Ultrastructure and Electron Microanalysis at the Core of Human Gallstones. II: Calcium Bilirubinate Stones

人體膽石核心之微細構造及電子微分析： II ：膽色素鈣石

柯成國(Chen-Guo Ker) ； 沈柏青(Pai-Ching Sheen)

《The Kaohsiung Journal of Medical Sciences》 1卷12期 (1985/12) Pp. 744-753

https://doi.org/10.6452/KJMS.198512.0744

摘要

利用掃描式電子顯微鏡及電子微分析人體膽色素鈣石之核心部份，這些膽石均從肝內外膽管部份取出者，目視下為深棕黃或咖啡色的，且以紅外線光譜分析法知其含有半數以上之膽色素鈣成分者，才為本研究之材料有 26 位膽石。膽色素鈣石之切片亦有些輪狀構造，其掃描電子顯微鏡下較不規則，其核心部份分成五種，第 I 型為成堆之小圓片狀有 11 位（占 42 . 31 ％），第II型為較平坦構造但其內有膜狀物網狀隔開，有 8 位（占 30 . 76 ％），第III型為蛔蟲之蟲卯有蟲體物存在有 3 位（占 11 . 53 ％），第 IV 型為中華肝吸蟲之蟲卵有 2 位（占 7 . 7 ％） , 及第 V 型為異狀物如纖維物或魚骨有 2 位（占 7 . 7 ％）。其金屬成份分佈膽色素鈣石了鈣以外尚有鋅、鋁、銅、硫等元素，鋅、鋁和銅等元素可能與膽色素結合有關，而硫成份可能與蛋白黏掖有關。一般言，膽色素鈣石之核心成分較其他膽石為複雜，細菌性或寄生蟲性感染，或不正常分泌黏液物均可能形成膽色素鈣石有關，而且含量高之鈣成份可能是結合小分子之膽色素的重要角色。寄生蟲之蟲體蟲卵及其他異物體均可造成膽色素鈣石之核心而漸漸形成較大之膽色素鈣石。

並列摘要

Calcium biirubinate stones were studied by scanning electron microscopy and electron microanalysis at the core of 26 stones. All stones had been studied with infrared spectroscopy and were found to be calcium biirubinate.
The ultrastructure at the core of calcium bilirubinate stones are classified into five types; Type I: cluster of thin and round sheets in 11 patients (42.31%); Type II: Homogeneous substance separated by reticular membranous structure in 8 patients (30.76%); Type III: egg or cuticle of ascaris in 3 patients (11.53%); Type IV: egg of clonorchis in 2 patients (7.7%) and Type V: foreign bodies such as fibers, or fish bone in 2 patients (7.7%).
The metal elements of calcium bilirubinate were Zn, Al, Cu, and S in addition to calcium. The ultrastructures of the central core of calcium bilirubinate stones were very complex. Bacterial or parasitic infection, and abnormal increasing mucosubstance in bile duct were initial factors in the formation of bilirubinate stones. Calcium was also a role acting as a bridge for coagulation of each component of calcium bilirubinate stones.

並列關鍵字

electron probe microanalysis ； scanning electromicroscopy ； calcium bilirubinate stone