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一、肝细胞的胆汁分泌机理胆汁系由肝细胞通过毛细胆管分泌入胆道,此一分泌过程的障碍或胆道阻塞,则导致胆汁郁积。目前认为肝细胞摄取胆红素可能有两种方式,一是非结合胆红素白蛋白复合体到达肝血窦后迅速分离,非结合胆红素以非离子扩散方式经过肝细胞膜进入细胞内,再与细胞内特殊胞浆蛋白结合。另一种可能是肝细胞膜有特异性受体摄取胆红素,再进入细胞内与特殊胞浆蛋白结合。这种特殊胞浆蛋白已分离出来,命名为Y和Z蛋白,这两种蛋白在肝细胞摄取胆红素的过程中起重要作用。非结合胆红素在肝细胞内要与葡萄糖醛酸结合转变为结合胆红素后才能从胆道排出。正常人胆汁中的胆红素98～99％是结合的,主要是胆红素葡萄糖醛酯。结合的部位于肝脏微粒体中,胆红素与葡萄糖醛酸结合,要经过一系列酶的催化作
First, the mechanism of bile secretion of liver cells Bile by the liver cells through the bile duct secretion into the biliary tract, the process of obstruction or biliary obstruction, lead to cholestasis. At present, liver cells may take up bilirubin may have two ways, first, unconjugated bilirubin complexes quickly after the arrival of hepatic sinusoids, non-conjugated bilirubin non-ionic diffusion through the liver cell membrane into the cell, and then With intracellular special cytoplasmic protein binding. Another possibility is that the liver cell membrane has a specific receptor uptake of bilirubin, and then enter the cell with a special cytoplasmic protein binding. This particular cytoplasmic protein has been isolated and named Y and Z proteins, both of which play an important role in the uptake of bilirubin by hepatocytes. Non-conjugated bilirubin in liver cells with glucuronic acid combined with bilirubin into bilirubin after discharge. Normal bile in the 98 to 99% of bilirubin is a combination of mainly bilirubin glucuronyl ester. Combined with the Ministry of the liver microsomes, bilirubin and glucuronic acid, to go through a series of enzyme catalysis