The distribution and monomer activity of cholesterol in micellar solution - its significance in gallstone formation -

通过观察胆固醇在胆囊中的分布、胆固醇单体的活性以及胆汁中脂质和蛋白质浓度与成核时间的关系，探讨胆固醇结石形成的原因。胆囊胆汁通过手术直接穿刺从两组胆石症患者或非肝胆疾病患者中获得。通过0.22 μ m膜过滤以除去胆固醇晶体的胆汁具有相似浓度的胆汁脂质和胆汁蛋白。胆固醇单体活性在两组之间没有显著差异。成核时间在胆结石患者中显著更快。通过XM-300膜的滤液具有相似的成核时间，这是由于胆结石组的成核时间延长。胆结石患者胆固醇、磷脂和胆汁蛋白的截留率较高，而胆盐的滤出率两组无显著差异。这些结果表明，不能通过XM-300膜的蛋白质而不是总蛋白质是胆固醇一水合物结晶的原因。主要由胆固醇和磷脂组成的囊泡的去除缩短了成核时间。胆固醇单体活性以及胆固醇饱和指数不能区分胆固醇结石病与对照组。

The differences in cholesterol distribution, cholesterol monomer activity and the concentrations of biliary lipids and protein related with nucleation time between the gallbladder biles with and without gallstone were examined to clarify the etiology of cholesterol gallstone formation. Gallbladder biles were obtained by the direct needle puncture at surgery from two groups of patients with cholelithisasis or with diseases other than hepatobiliary disease. The filtered biles through the 0.22 um membrane to remove cholesterol crystals had similar concentrations of biliary lipids and biliary proteins. Cholesterol monomer activity was not significantly different between two groups. nucleation time was significantly faster in gallstone patients. The filtrate through the XM-300 membrane had a similar nucleation time due to the prolonged nucleation time in gallstone group. This filtration retained more cholesterol, phospholipid and biliary protein in gallstone patients, while the filtration rate of bile salt was similar between two groups. These results suggest that the protein which cannot pass through the XM-300 membrane but not the total protein is responsible for cholesterol monohydrate crystallization. The removal of vesicles mainly composed of cholesterol and phospholipid prolongs the nucleation time. Cholesterol monomer activity as well as cholesterol saturation index cannot distinguish cholesterol gallstone disease from control.