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本文复习有关色素性胆石病的若干进展。色素性胆石可分为棕色和黑色两大类。前者又称为胆红素性结石或胆色素钙结石,多见于东方人。与胆固醇结石比较,色素性结石在女性中发病率较低。棕色和黑色结石的主要成分是胆红素钙,两者的主要区别在于后者含有的胆红素钙聚合程度较高。50%黑色结石不透X线,而棕色结石可透X线。正常胆汁中某些成分增加并超过其溶解度、促溶物质成分减少或有外来物质存在均可引起胆汁成分的析出和聚集。溶血、胆汁中胆红素IXα、钙离子、卵磷酯以及细菌合成的β-葡萄糖醛酸酶对本病的发生可能有一定影响。
This article reviews some of the progress of the pigment gallstone disease. Pigmented gallstones can be divided into two major categories of brown and black. The former is also known as bilirubin or gallstone calcium calculus, more common in Asians. Compared with cholesterol stones, pigmented stones in women with a lower incidence. The main component of brown and black stones is bilirubin, the main difference between the two is that the latter contains a higher degree of polymerization of calcium bilirubinate. 50% black stone does not penetrate the X-ray, while the brown stone can penetrate the X-ray. Normal bile in some of the ingredients to increase and exceed its solubility, reduce the solubility of substances or the presence of foreign substances can cause the precipitation and accumulation of bile components. Hemolysis, bile bilirubin IXα, calcium, lecithin and bacterial synthesis of β-glucuronidase may have some impact on the occurrence of the disease.