摘要【目的】探讨胆囊收缩功能障碍及缩胆囊素（CCK）A受体（AR）与胆囊结石的关系，为临床明确保胆手术适应证提供理论依据。【方法】B超测量息肉组、结石组胆囊的胆囊壁厚度，长、宽、横径，计算胆囊收缩率，酶免疫组织化学法染色，观察胆囊壁中CCK-AR分子蛋白表达水平。【结果】①结石组胆囊壁厚度明显高于息肉组（ P ＜0．05）；②结石组胆囊收缩率明显低于息肉组（ P ＜0．05）。③结石组胆囊收缩率与胆囊壁厚度二者呈显著负相关。④结石组平滑肌CCK-AR低于息肉组（ P＜0．01）。⑤结石组患者的胆囊收缩率与平滑肌CCK-AR蛋白表达阳性细胞数二者呈显著正相关。【结论】①胆囊收缩功能障碍与CCK-AR减少有关。②胆囊结石患者胆囊壁厚度与胆囊收缩功能成明显负相关。③保胆手取石术的基本条件是胆囊收缩率＞50％，胆囊壁厚度＜0．30 cm。
Abstract：[Objective] To explore the correlation of gallbladder contraction dysfunction and cholecystokinin (CCK ) A re-ceptor(AR) with gallbladder stone in order to provide the theoretical basis for identifying the indications of gallbladder-preser-ving cholelithotomy .[Methods]Type-B ultrasound was used to measure gallbladder wall thickness ,length ,width and trans diameter in gallbladder polyps group and stone groups .Gallbladder contraction efficiency was calculated .Enzyme immunohis-tochemical method was used for staining .The expression of CCK-AR in gallbladder wall was observed .[Results]The thick-ness of gallbladder wall in gallbladder stone group was obviously higher than that in gallbladder polyps group ( P <0 .05) . Gallbladder contraction efficiency in gallbladder stone group was obviously lower than that in gallbladder polyps group ( P <0 .05) .There was significantly negative correlation between gallbladder contraction efficiency and the thickness of gallbladder wall in gallbladder stone group .The expression of CCK-AR in gallbladder stone group was lower than that in gallbladder pol-yps group( P<0 .0) .There was significantly positive correlation between gallbladder contraction efficiency and the cell num-ber of positive expression of CCK-AR in smooth muscle of gallbladder stone group .[Conclusion]Gallbladder contraction effi-ciency is associated with the decreasing of CCK-AR .There is negative correlation between gallbladder wall thickness and gall-bladder contraction efficiency in patients with gallbladder stone .The basic conditions for gallbladder-preserving cholelithotomy are gallbladder contraction efficiency>50% and gallbladder wall thickness<0 .30cm .
引用本文:
南云广%丁海波%刘大林. 保胆取石手术适应证的初步探讨[J]. 医学临床研究, 2014, 31(3): 513-516.
NANG Yun-guang%DING Hai-bo%LIU Da-lin. Preliminary Study on the Indications for Gallbladder-preserving Cholelithotomy. 医学临床研究, 2014, 31(3): 513-516.
2014, Vol. 31 
