The Analysis of Stone Formation Factors in Bile Juice: Emphasis on Bile Viscosity and Mucin Glycoprotein

膽汁中膽結石發生相關因子之探討：著重於膽汁黏度及黏液醣蛋白

葉宏仁(Hong-Zen Yeh) ； 陳儉鏗(Gran-Hum Chen) ； 鄭毓平(Yu-Ping Cheng) ； 吳誠中(Chen-Chun Wu) ； 劉自嘉(Tse-Jia Liu)

《中華民國消化系醫學會雜誌》 10卷2期 (1993/06) Pp. 149-156

https://doi.org/10.6557/GJTa.199306_10(2).0003

摘要

In order to evaluate the physical characteristics of bile juice and the contributing factors of gallstone formation, viscosity and the amount of mucin glycoprotein (hexosamine as a marker) of bile juice was determined for analysis. Gallbladder bile was obtained from 35 patients (including 17 GBS patients and 18 normal control subjects). T-tube bile (A bile) was obtained from 61 patients (including 11 GBS, 23 CBDS and 27 IHDS patients). Bile duct bile (B bile) collected other than from T-tube was obtained from 47 patients (including 7 normal control subjects, 8 GBS, 21 CBDS and 11 IHDS patients). The mean relative viscosity of whole gallbladder bile was 3.6±2.1 (n=35), which was significantly higher than that of A bile (1.37±0.25, n=61, p＜0.001) and B bile (1.34±0.16, n=47, p＜0.001). In gallbladder bile, the relative viscosity was correlated with dry weight (r=0.52, p＜0.001) and hexosamine concentration (r=0.45, p＜0.005). No significant difference of mean viscosity value was noted among the subject groups either in gallbladder bile or in bile duct bile. As for the amount of mucin glycoprotein, there was no significant difference of the mean concentration of hexosamine (µ g/ml) between the gallbladder stone patients and the control subjects. However, with the expression of mg hexosamine/gm bile dry weight, the mean value of the gallbladder stone patients was 8.7±17.2 mg/gm (n=17) which was significantly higher than the mean value of control subjects (2.1±1.2 mg/gm, n=18, p＜0.001). In bile duct bile, with the same way of expression (mg hexosamine/gm bile dry weight) the mean value of intrahepatic duct stone patients was significantly higher than that of gallbladder stone patients and common bile duct stone patients. The p value was smaller than with the expression of concentration. The above results suggest that: 1) the mucous substances contribute to the viscous property of gallbladder bile; 2) the mucous substances play an important role in the formation of gallbladder stones and the intrahepatic duct stones; and 3) the way of expression of hexosamine content as a function of the total solid in the bile may more accurately quantitate the amount of mucin glycoprotein than the way of expression as concentration.

關鍵字

膽汁黏度 ； 黏液醣蛋白 ； 結石發生因子

並列摘要

In order to evaluate the physical characteristics of bile juice and the contributing factors of gallstone formation, viscosity and the amount of mucin glycoprotein (hexosamine as a marker) of bile juice was determined for analysis. Gallbladder bile was obtained from 35 patients (including 17 GBS patients and 18 normal control subjects). T-tube bile (A bile) was obtained from 61 patients (including 11 GBS, 23 CBDS and 27 IHDS patients). Bile duct bile (B bile) collected other than from T-tube was obtained from 47 patients (including 7 normal control subjects, 8 GBS, 21 CBDS and 11 IHDS patients). The mean relative viscosity of whole gallbladder bile was 3.6±2.1 (n=35), which was significantly higher than that of A bile (1.37±0.25, n=61, p＜0.001) and B bile (1.34±0.16, n=47, p＜0.001). In gallbladder bile, the relative viscosity was correlated with dry weight (r=0.52, p＜0.001) and hexosamine concentration (r=0.45, p＜0.005). No significant difference of mean viscosity value was noted among the subject groups either in gallbladder bile or in bile duct bile. As for the amount of mucin glycoprotein, there was no significant difference of the mean concentration of hexosamine (µ g/ml) between the gallbladder stone patients and the control subjects. However, with the expression of mg hexosamine/gm bile dry weight, the mean value of the gallbladder stone patients was 8.7±17.2 mg/gm (n=17) which was significantly higher than the mean value of control subjects (2.1±1.2 mg/gm, n=18, p＜0.001). In bile duct bile, with the same way of expression (mg hexosamine/gm bile dry weight) the mean value of intrahepatic duct stone patients was significantly higher than that of gallbladder stone patients and common bile duct stone patients. The p value was smaller than with the expression of concentration. The above results suggest that: 1) the mucous substances contribute to the viscous property of gallbladder bile; 2) the mucous substances play an important role in the formation of gallbladder stones and the intrahepatic duct stones; and 3) the way of expression of hexosamine content as a function of the total solid in the bile may more accurately quantitate the amount of mucin glycoprotein than the way of expression as concentration.

並列關鍵字

bile viscosity ； mucin glycoprotein ； stone formation factor