胆固醇结石的发病机制与治疗

阎良, 黄建平. 胆固醇结石的发病机制与治疗[J]. 中国中西医结合消化杂志, 2022, 30(9): 679-684. doi: 10.3969/j.issn.1671-038X.2022.09.13
引用本文: 阎良, 黄建平. 胆固醇结石的发病机制与治疗[J]. 中国中西医结合消化杂志, 2022, 30(9): 679-684. doi: 10.3969/j.issn.1671-038X.2022.09.13
YAN Liang, HUANG Jianping. Review on the pathogenesis and treatment of cholesterol stones[J]. Chin J Integr Tradit West Med Dig, 2022, 30(9): 679-684. doi: 10.3969/j.issn.1671-038X.2022.09.13
Citation: YAN Liang, HUANG Jianping. Review on the pathogenesis and treatment of cholesterol stones[J]. Chin J Integr Tradit West Med Dig, 2022, 30(9): 679-684. doi: 10.3969/j.issn.1671-038X.2022.09.13

胆固醇结石的发病机制与治疗

  • 基金项目:
    上海中医药大学预算内项目(No:2020LK050)
详细信息

Review on the pathogenesis and treatment of cholesterol stones

More Information
  • 胆囊结石是整个世界范围内的常见消化道疾病之一,一旦出现并发症,会产生重大的经济和社会负担。胆囊结石中大部分患者为胆固醇结石。该文分析胆固醇结石的西医发病机制以及中医病因病机,同时进一步总结了胆固醇结石的治疗方法,从现代医学和传统医学角度提供胆固醇结石的诊疗思路。
  • 加载中
  • [1]

    Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part Ⅲ: liver, biliary tract, and pancreas[J]. Gastroenterology, 2009, 136(4): 1134-1144. doi: 10.1053/j.gastro.2009.02.038

    [2]

    Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?[J]. Curr Gastroenterol Rep, 2005, 7(2): 132-140. doi: 10.1007/s11894-005-0051-8

    [3]

    中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科医师委员会. 胆囊良性疾病外科治疗的专家共识(2021版)[J]. 中华外科杂志, 2022, 60(1): 4-9.

    [4]

    冯矗, 罗浩, 万柳华, 等. 胆囊结石药物治疗现状[J]. 临床军医杂志, 2022, 50(5): 544-546. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGZ202205028.htm

    [5]

    冯健, 崔乃强. 中西医结合治疗胆石病的现状与展望[J]. 临床肝胆病杂志, 2018, 34(4): 704-709. doi: 10.3969/j.issn.1001-5256.2018.04.005

    [6]

    米利晓, 孙建男, 赵恒宇. 影像学方法鉴别胆囊结石成分的研究进展[J]. 中国临床医学影像杂志, 2018, 29(3): 215-217. https://www.cnki.com.cn/Article/CJFDTOTAL-LYYX201803020.htm

    [7]

    Lammert F, Gurusamy K, Ko CW, et al. Gallstones[J]. Nat Rev Dis Primers, 2016, 2: 16024. doi: 10.1038/nrdp.2016.24

    [8]

    张中文, 蒋兆彦, 韩天权, 等. 胆石病的流行病学和危险因素[J]. 外科理论与实践, 2011, 16(4): 408-412. https://www.cnki.com.cn/Article/CJFDTOTAL-WKLL201104023.htm

    [9]

    韩天权, 崔巍, 张圣道. 胆石形成机制基础与临床研究[J]. 中国实用外科杂志, 2009, 29(7): 599-601. doi: 10.3321/j.issn:1005-2208.2009.07.024

    [10]

    Ibiebele I, Schnitzler M, Nippita T, et al. Outcomes of gallstone disease during pregnancy: a population-based data linkage study[J]. Paediatr Perinat Epidemiol, 2017, 31(6): 522-530. doi: 10.1111/ppe.12406

    [11]

    National Institute for Health and Care Excellence. Clinical Guidelines: Developmental Follow-up of Children and Young People Born Preterm(NG72). Published: 9 August 2017.

    [12]

    Di Ciaula A, Wang DQ, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease[J]. Curr Opin Gastroenterol, 2018, 34(2): 71-80. doi: 10.1097/MOG.0000000000000423

    [13]

    Hsing AW, Bai Y, Andreotti G, et al. Family history of gallstones and the risk of biliary tract cancer and gallstones: a population-based study in Shanghai, China[J]. Int J Cancer, 2007, 121(4): 832-838. doi: 10.1002/ijc.22756

    [14]

    Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease[J]. Lancet, 2006, 368(9531): 230-239. doi: 10.1016/S0140-6736(06)69044-2

    [15]

    Khanuja B, Cheah YC, Hunt M, et al. Lith1, a major gene affecting cholesterol gallstone formation among inbred strains of mice[J]. Proc Natl Acad Sci USA, 1995, 92(17): 7729-7733. doi: 10.1073/pnas.92.17.7729

    [16]

    Wang TY, Portincasa P, Liu M, et al. Mouse models of gallstone disease[J]. Curr Opin Gastroenterol, 2018, 34(2): 59-70. doi: 10.1097/MOG.0000000000000417

    [17]

    Lyons MA, Wittenburg H. Cholesterol gallstone susceptibility loci: a mouse map, candidate gene evaluation, and guide to human LITH genes[J]. Gastroenterology, 2006, 131(6): 1943-1970. doi: 10.1053/j.gastro.2006.10.024

    [18]

    Joshi AD, Andersson C, Buch S, et al. Four susceptibility loci for gallstone & disease identified in a meta-analysis of genome-wide association Studies[J]. Gastroenterology, 2016, 151(2): 351-363. doi: 10.1053/j.gastro.2016.04.007

    [19]

    Grunhage F, Acalovschi M, Tirziu S, et al. Increased gallstone risk in humans conferred by common variant of hepatic ATP-binding cassette transporter for cholesterol[J]. Hepatology, 2007, 46(3): 793-801. doi: 10.1002/hep.21847

    [20]

    Von Schonfels W, Buch S, Wolk M, et al. Recurrence of gallstones after cholecystectomy is associated with ABCG5/8 genotype[J]. J Gastroenterol, 2013, 48(3): 391-396. doi: 10.1007/s00535-012-0639-3

    [21]

    Xu HL, Cheng JR, Andreotti G, et al. Cholesterol metabolism gene polymorphisms and the risk of biliary tract cancers and stones: a populationbased case-control study in Shanghai, China[J]. Carcinogenesis, 2011, 32(1): 58-62. doi: 10.1093/carcin/bgq194

    [22]

    Hirobe-Jahn S, Harsch S, Renner O, et al. Association of FXR gene variants with cholelithiasis[J]. Clin Res Hepatol Gastroenterol, 2015, 39(1): 68-79. doi: 10.1016/j.clinre.2014.07.002

    [23]

    Chen Q, Li WJ, Wan YY, et al. Fibroblast growth factor receptor 4 Gly388Arg polymorphism associated with severity of gallstone disease in a Chinese population[J]. Genet Mol Res, 2012, 11(1): 548-555. doi: 10.4238/2012.March.8.3

    [24]

    Di Ciaula A, Portincasa P. Fat, epigenome and pancreatic diseases. Interplay and common pathways from a toxic and obesogenic environment[J]. Eur J Intern Med, 2014, 25(10): 865-873. doi: 10.1016/j.ejim.2014.10.012

    [25]

    Moore KJ, Rayner KJ, Suarez Y, et al. MicroRNAs and cholesterol metabolism[J]. Trends Endocrinol Metab, 2010, 21(12): 699-706. doi: 10.1016/j.tem.2010.08.008

    [26]

    Portincasa P, Di Ciaula A, de Bari O, et al. Management of gallstones and its related complications[J]. Expert Rev Gastroenterol Hepatol, 2016, 10(1): 93-112. doi: 10.1586/17474124.2016.1109445

    [27]

    Xie Y, Cifarelli V, Pietka T, et al. CD36 knockout mice are protected against & lithogenic diet-induced gallstones[J]. J Lipid Res, 2017, 58(8): 1692-1701. doi: 10.1194/jlr.M077479

    [28]

    Ye X, Shen S, Xu Z, et al. Sodium butyrate alleviates cholesterol gallstones by regulating bile acid metabolism[J]. Eur J Pharmacol, 2021, 908: 174341. doi: 10.1016/j.ejphar.2021.174341

    [29]

    Wang DQ, Zhang L, Wang HH. High cholesterol absorption efficiency and rapid biliary secretion of chylomicron remnant cholesterol enhance cholelithogenesis in gallstone-susceptible mice[J]. Biochim Biophys Acta, 2005, 1733(1): 90-99. doi: 10.1016/j.bbalip.2004.12.005

    [30]

    Wang HH, Portincasa P, Mendez-Sanchez N, et al. Effect of ezetimibe on the prevention and dissolution of cholesterol gallstones[J]. Gastroenterology, 2008, 134(7): 2101-2110. doi: 10.1053/j.gastro.2008.03.011

    [31]

    Shabanzadeh DM. New determinants for gallstone disease[J]. Dan Med J, 2018, 65(2): B5438.

    [32]

    Wang HH, Portincasa P, Liu M, et al. An Update on the Lithogenic Mechanisms of Cholecystokinin a Receptor(CCKAR), an Important Gallstone Gene for Lith13[J]. Genes(Basel), 2020, 11(12): 1438.

    [33]

    Tharp KM, Khalifeh-Soltani A, Park HM, et al. Prevention of gallbladder hypomotility via FATP2 inhibition protects from lithogenic diet-induced cholelithiasis[J]. Am J Physiol Gastrointest Liver Physiol, 2016, 310(10): 855-864. doi: 10.1152/ajpgi.00316.2015

    [34]

    Wang HH, Portincasa P, Wang DQ. Molecular pathophysiology and physical chemistry of cholesterol gallstones[J]. Front Biosci, 2008, 13: 401-423. doi: 10.2741/2688

    [35]

    Lavoie B, Nausch B, Zane EA, et al. Disruption of gallbladder smooth muscle function is an early feature in the development of cholesterol gallstone disease[J]. Neurogastroenterol Motil, 2012, 24(7): 313-324. doi: 10.1111/j.1365-2982.2012.01935.x

    [36]

    唐亚, 廖日斌, 薛力玮, 等. 炎症介导的PI3K/Akt/Sp1信号通路激活及内源性H_2S生成加剧重症急性胰腺炎肠道损伤[J]. 中国病理生理杂志, 2019, 35(8): 1475-1482. https://www.cnki.com.cn/Article/CJFDTOTAL-ZBLS201908020.htm

    [37]

    Wang HH, Liu M, Portincasa P, et al. Lack of endogenous cholecystokinin promotescholelithogenesis inmice[J]. Neurogastroenterol Motil, 2016, 28(3): 364-375. doi: 10.1111/nmo.12734

    [38]

    Wang HH, Portincasa P, Wang DQ. The cholecystokinin-1 receptor antagonist devazepide increases cholesterol cholelithogenesis in mice[J]. Eur J Clin Invest, 2016, 46(2): 158-169. doi: 10.1111/eci.12580

    [39]

    Nakeeb A, Comuzzie AG, Al-Azzawi H, et al. Insulin resistance causes human gallbladder dysmotility[J]. J Gastrointest Surg, 2006, 10(7): 940-948. doi: 10.1016/j.gassur.2006.04.005

    [40]

    Ding X, Lu CY, Mei Y, et al. Correlation between gene expression of CCK-A receptor and emptying dysfunction of the gallbladder in patients with gallstones and diabetes mellitus[J]. Hepatobiliary Pancreat Dis Int, 2005, 4(2): 295-298.

    [41]

    Choi M, Moschetta A, Bookout AL, et al. Identification of a hormonal basis for gallbladder filling[J]. Nat Med, 2006, 12(11): 1253-1255. doi: 10.1038/nm1501

    [42]

    Zhou M, Learned RM, Rossi SJ, et al. Engineered fibroblast growth factor 19 reduces liver injury and resolves sclerosing cholangitis in Mdr2-deficient mice[J]. Hepatology, 2016, 63(3): 914-929. doi: 10.1002/hep.28257

    [43]

    Lammert F, Acalovschi M, Ercolani G, et al. EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones[J]. J Hepatol, 2016, 65(1): 146-181. doi: 10.1016/j.jhep.2016.03.005

    [44]

    Wu T, Zhang Z, Liu B, et al. Gut microbiota dysbiosis and bacterial community assembly associated with cholesterol gallstones in large-scale study[J]. BMC Genomics, 2013, 14: 669. doi: 10.1186/1471-2164-14-669

    [45]

    Wang Q, Jiao L, He C, et al. Alteration of gut microbiota in association with & cholesterol gallstone formation in mice[J]. BMC Gastroenterol, 2017, 17(1): 74. doi: 10.1186/s12876-017-0629-2

    [46]

    Hu H, Shao W, Liu Q, et al. Gut microbiota promotes cholesterol gallstone formation by modulating bile acid composition and biliary cholesterol secretion[J]. Nat Commun, 2022, 13(1): 252. doi: 10.1038/s41467-021-27758-8

    [47]

    Bertola-Compagnucci A, Perroud HA, Batalles SM, et al. A nested casecontrol study on dietary fat consumption and the risk for gallstone disease[J]. J Hum Nutr Diet, 2016, 29(3): 338-344. doi: 10.1111/jhn.12332

    [48]

    郑明华, 主译. 肝胆病学[M]. 12版. 北京: 人民卫生出版社, 2014.

    [49]

    蒋晨春, 刘昕, 雷朝君, 等. 内镜联合术式用于胆囊并胆总管结石的效果及对疼痛的影响[J]. 中国中西医结合消化杂志, 2020, 28(1): 35-38. doi: 10.3969/j.issn.1671-038X.2020.01.10

    [50]

    中华消化杂志编辑委员会, 中华医学会消化病学分会肝胆疾病协作组, 上海交通大学医学院附属瑞金医院消化内科, 等. 中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2014年, 上海)[J]. 临床肝胆病杂志, 2015, 31(1): 7-11. https://www.cnki.com.cn/Article/CJFDTOTAL-LCGD201501004.htm

    [51]

    中国中西医结合学会消化系统疾病专业委员会. 胆石症中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(2): 132-137. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201802004.htm

    [52]

    中国中西医结合学会消化系统疾病专业委员会. 急性胆囊炎中西医结合诊疗共识意见[J]. 中国中西医结合消化杂志, 2018, 26(10): 805-811. doi: 10.3969/j.issn.1671-038X.2018.10.01

    [53]

    舒新华, 万喜兴, 黄海英. 清胆汤加减在胆囊颈部结石嵌顿合并胆道泥沙样结石术后的临床应用[J]. 江西中医药, 2013, 44(9): 36-37. https://www.cnki.com.cn/Article/CJFDTOTAL-JXZY201309019.htm

    [54]

    张建斌, 曹岐新, 王群. 柴胡疏肝散合参苓白术散加减治疗胆囊切除术后慢性腹泻60例[J]. 中国中医药科技, 2018, 25(5): 735-737. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYY201805051.htm

    [55]

    任明振. 清胆逐瘀方对胆囊切除术后患者胃肠功能恢复及炎症因子的影响[J]. 光明中医, 2021, 36(13): 2209-2211. https://www.cnki.com.cn/Article/CJFDTOTAL-GMZY202113040.htm

  • 加载中
计量
  • 文章访问数:  1132
  • PDF下载数:  848
  • 施引文献:  0
出版历程
收稿日期:  2022-04-08
刊出日期:  2022-09-15

目录