胆固醇结石病人胆汁免疫球蛋白含量增高及其对胆固醇-磷脂泡的影响

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目的 :研究胆固醇结石病人胆囊胆汁、胆总管胆汁、血清3种免疫球蛋白(immunoglobulin,Ig)含量及其对胆固醇-磷脂泡变化的影响。方法:通过Con A亲和层析与Sephadex G-200分子筛凝胶两次过滤,从胆囊胆固醇结石病人及胆囊胆色素结石病人、无结石对照病人、非结石急性胆囊炎病人以及白胆汁病人胆囊胆汁、胆总管胆汁和血清中分离提纯Ig A、Ig G和Ig M;应用单向免疫扩散法检测3种Ig含量;应用电子显微镜观察Ig在模拟胆汁体系对胆固醇-磷脂泡的影响。结果:胆固醇结石组胆囊胆汁含有较高浓度的Ig G和Ig M,胆总管胆汁的3种Ig含量增高。胆色素结石组胆总管胆汁Ig A、Ig M含量与对照组无差异。胆固醇结石组和胆色素结石组除血清Ig A含量低于对照组外,其余Ig含量与对照组无差异。胆固醇结石组胆囊胆汁Ig G和Ig M分别作用于模拟胆汁7 d,明显促使单层泡直径增大,且增加多层泡数量;而Ig A仅轻微增加单层泡直径,不影响多层泡数量。结论:本实验结果显示,胆固醇结石组胆汁中Ig增高,可能通过影响胆固醇-磷脂泡变化,促进胆固醇结石形成。 Objective: To study the contents of three kinds of immunoglobulin (Ig) in gallbladder bile, common bile duct and serum in patients with cholesterol gallstone and their effects on the changes of cholesterol-phosphatidylinositol. Methods: Con A affinity chromatography and Sephadex G-200 gel filtration twice, from gallbladder patients with gallstone and gallbladder gallstone patients, non-stone control patients, patients with non-stone acute cholecystitis and gallbladder bile gallbladder patients , IgA, Ig G and Ig M were isolated and purified from choledochus and sera of common bile duct. The contents of three Ig were detected by one-way immunodiffusion method. The effect of Ig on cholesterol-phospholipid bleb was simulated by electron microscope. Results: Cholesterol gallstone gallbladder bile contains a higher concentration of Ig G and Ig M, bile cholelithiasis three Ig content increased. There was no significant difference in the content of bile IgA and IgM in the common bile duct stones between the control group and the control group. Cholesterol stones and bile pigment stones group serum Ig A levels lower than the control group, the rest of Ig content and the control group no difference. Cholesterol stones group gallbladder Ig G and Ig M, respectively, in simulated bile 7 d, significantly promote the single-bubble diameter increased, and increase the number of multi-lamellar; and Ig A only slightly increased the diameter of single-lamellar, does not affect the multi-layer bubble Quantity. Conclusion: The results of this experiment showed that Ig increased in bile of cholesterol gallstone group, which may promote the formation of cholesterol calculus by affecting the changes of cholesterol-phospholipid vesicles.
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