目的:探讨依泽替米贝辅助腹腔镜微创术联合治疗胆囊结石患者对炎性因子及胆囊收缩素A(Cholecystokinin-A,CCK-A)表达的影响。方法:以2016年2月-2018年2月我院收治的100例胆囊结石患者作为研究对象,按随机数字表法分为对照组(腹腔镜微创...目的:探讨依泽替米贝辅助腹腔镜微创术联合治疗胆囊结石患者对炎性因子及胆囊收缩素A(Cholecystokinin-A,CCK-A)表达的影响。方法:以2016年2月-2018年2月我院收治的100例胆囊结石患者作为研究对象,按随机数字表法分为对照组(腹腔镜微创术)和观察组(腹腔镜微创术+依泽替米贝),每组各50例。观察并比较治疗前后两组患者临床疗效、胆囊结石数量和直径的变化、炎性因TNF-α、IL-1水平以及血清CCK-A水平的变化。结果:术后观察组感染2例,胰腺炎1例,观察组发生感染3例,两组患者并发症发生情况差异无统计学意义(P<0.05),观察组患者的治疗有效率明显高于对照组(94.0%vs 58.0%)(P<0.05);治疗前两组患者胆囊结石平均数量、直径差异无统计学意义(P>0.05),治疗后观察组和对照组患者胆囊结石数量(5.16±2.35 vs9.18±2.82)、直径(0.78±0.29 cm vs 1.26±0.36 cm)明显降低,观察组低于对照组(P<0.05);治疗前两组患者血清TNF和IL-1水平无明显差异(P>0.05),治疗后观察组和对照组患者血清TNF-α[15.28±4.28(ng/mg)vs 22.19±5.02(ng/mg)]、IL-1[63.38±8.27(μg/mg)vs 89.59±7.39(μg/mg)]水平明显降低,且观察组明显低于对照组(P<0.05);治疗前两组患者血清CCK-A水平无明显差异(P>0.05),治疗后观察组和对照组患者血清CCK-A水平[121.36±10.47(ng/mg)vs 115.39±10.39(ng/mg)]明显升高,且观察组高于对照组(P<0.05)。结论:依泽替米贝辅助腹腔镜微创术能有效减少胆囊结石患者的结石数量、降低结石直径,并且可以降低患者血清炎性因子水平,促进CCK-A表达,减轻胆囊炎症反应,缓解患者痛苦,有较好的临床效果。展开更多
BACKGROUND: The incidence of gallstone is higher in patients with diabetes mellitus than in general population because of hypomotility and lowered emptying function. The aim of this study was to investigate the gene e...BACKGROUND: The incidence of gallstone is higher in patients with diabetes mellitus than in general population because of hypomotility and lowered emptying function. The aim of this study was to investigate the gene expression of cholecystokinin-A ( CCK-A) receptor in patients with gallstones and diabetes mellitus and its correlation with the hypomotility of the gallbladder. METHODS: Smooth muscle was taken from the gallbladder after cholecystectomy and total RNA was extracted from it by Trizol reagent to compose cDNA. CCK-A receptor was enlarged by reverse transcription-polymerase chain reaction (RT-PCR) and identified by electrophoresis. Based on the analysis of images, the relative expression of the CCK-A re- ceptor was obtained after comparison of the CCK-A recep- tor and β-action. The emptying function of the gallbladder was measured with B ultrasound before operation. RESULTS: Gallbladder ejetion fraction ( GBEF2 ) (%) (24.9±12.7) decreased more significantly in patients with gallstones and diabetes mellitus than in those with simple gallstone (61.5±8.5) (P <0.01). In the two groups, a frac- tion of 540bp of CCK-A receptor could be testified respec- tively, but the relative expression was different. Compared to the expression of β-action, it was 0. 400 ±0.068 in pa- tients with gallstones and diabetes mellitus, but 0. 622 ± 0.070 in those with gallstone only (F =7.169, P <0.01). The result was consistent with the decreased contractility. CONCLUSIONS: The gene expression of CCK-A receptor on the smooth muscle of the gallbladder may decrease more significantly in patients with gallstone and diabetes mellitus than in those with gallstone only; this result is con- sistent with the decreased motih'ty. Thus the lowered ex- pression of CCK-A receptor is probably the cause of hypo-motility in patients with gallstones and diabetes mellitus.展开更多
目的分析腹腔镜胆囊切除术(LC)对胆结石患者血清胆囊收缩素A型受体(CCK-A)、固醇调节元件结合蛋白2(SREBP-2)及胆红素(TCB)水平的影响。方法选取2017年6月至2019年4月我院收治的胆结石患者140例,依据非随机临床同期对照研究及患者自愿...目的分析腹腔镜胆囊切除术(LC)对胆结石患者血清胆囊收缩素A型受体(CCK-A)、固醇调节元件结合蛋白2(SREBP-2)及胆红素(TCB)水平的影响。方法选取2017年6月至2019年4月我院收治的胆结石患者140例,依据非随机临床同期对照研究及患者自愿原则分为观察组合和对照组各70例。对照组予以小切口胆囊切除术(MC),观察组予以LC术,比较两组手术一般情况、手术前后血清CCK-A、SREBP-2、TCB、疼痛(简化McGill疼痛问卷)、并发症发生率。结果观察组手术时间、术后住院时间、肠鸣音复常时间、下地活动时间均短于对照组,术中出血量较对照组低(P<0.05);观察组术后CCK-A水平高于对照组,SREBP-2、TCB低于对照组(P<0.05);观察组术后1、3、7 d McGill评分低于对照组(P<0.05),术后1个月内并发症发生率低于对照组(P<0.05)。结论与MC术相比,LC术治疗胆结石疗效更好,可有效促进患者术后恢复,提高CCK-A水平,下调SREBP-2、TCB及炎症因子水平,降低疼痛和并发症风险,值得临床推广实践。展开更多
文摘目的:探讨依泽替米贝辅助腹腔镜微创术联合治疗胆囊结石患者对炎性因子及胆囊收缩素A(Cholecystokinin-A,CCK-A)表达的影响。方法:以2016年2月-2018年2月我院收治的100例胆囊结石患者作为研究对象,按随机数字表法分为对照组(腹腔镜微创术)和观察组(腹腔镜微创术+依泽替米贝),每组各50例。观察并比较治疗前后两组患者临床疗效、胆囊结石数量和直径的变化、炎性因TNF-α、IL-1水平以及血清CCK-A水平的变化。结果:术后观察组感染2例,胰腺炎1例,观察组发生感染3例,两组患者并发症发生情况差异无统计学意义(P<0.05),观察组患者的治疗有效率明显高于对照组(94.0%vs 58.0%)(P<0.05);治疗前两组患者胆囊结石平均数量、直径差异无统计学意义(P>0.05),治疗后观察组和对照组患者胆囊结石数量(5.16±2.35 vs9.18±2.82)、直径(0.78±0.29 cm vs 1.26±0.36 cm)明显降低,观察组低于对照组(P<0.05);治疗前两组患者血清TNF和IL-1水平无明显差异(P>0.05),治疗后观察组和对照组患者血清TNF-α[15.28±4.28(ng/mg)vs 22.19±5.02(ng/mg)]、IL-1[63.38±8.27(μg/mg)vs 89.59±7.39(μg/mg)]水平明显降低,且观察组明显低于对照组(P<0.05);治疗前两组患者血清CCK-A水平无明显差异(P>0.05),治疗后观察组和对照组患者血清CCK-A水平[121.36±10.47(ng/mg)vs 115.39±10.39(ng/mg)]明显升高,且观察组高于对照组(P<0.05)。结论:依泽替米贝辅助腹腔镜微创术能有效减少胆囊结石患者的结石数量、降低结石直径,并且可以降低患者血清炎性因子水平,促进CCK-A表达,减轻胆囊炎症反应,缓解患者痛苦,有较好的临床效果。
文摘BACKGROUND: The incidence of gallstone is higher in patients with diabetes mellitus than in general population because of hypomotility and lowered emptying function. The aim of this study was to investigate the gene expression of cholecystokinin-A ( CCK-A) receptor in patients with gallstones and diabetes mellitus and its correlation with the hypomotility of the gallbladder. METHODS: Smooth muscle was taken from the gallbladder after cholecystectomy and total RNA was extracted from it by Trizol reagent to compose cDNA. CCK-A receptor was enlarged by reverse transcription-polymerase chain reaction (RT-PCR) and identified by electrophoresis. Based on the analysis of images, the relative expression of the CCK-A re- ceptor was obtained after comparison of the CCK-A recep- tor and β-action. The emptying function of the gallbladder was measured with B ultrasound before operation. RESULTS: Gallbladder ejetion fraction ( GBEF2 ) (%) (24.9±12.7) decreased more significantly in patients with gallstones and diabetes mellitus than in those with simple gallstone (61.5±8.5) (P <0.01). In the two groups, a frac- tion of 540bp of CCK-A receptor could be testified respec- tively, but the relative expression was different. Compared to the expression of β-action, it was 0. 400 ±0.068 in pa- tients with gallstones and diabetes mellitus, but 0. 622 ± 0.070 in those with gallstone only (F =7.169, P <0.01). The result was consistent with the decreased contractility. CONCLUSIONS: The gene expression of CCK-A receptor on the smooth muscle of the gallbladder may decrease more significantly in patients with gallstone and diabetes mellitus than in those with gallstone only; this result is con- sistent with the decreased motih'ty. Thus the lowered ex- pression of CCK-A receptor is probably the cause of hypo-motility in patients with gallstones and diabetes mellitus.
文摘目的分析腹腔镜胆囊切除术(LC)对胆结石患者血清胆囊收缩素A型受体(CCK-A)、固醇调节元件结合蛋白2(SREBP-2)及胆红素(TCB)水平的影响。方法选取2017年6月至2019年4月我院收治的胆结石患者140例,依据非随机临床同期对照研究及患者自愿原则分为观察组合和对照组各70例。对照组予以小切口胆囊切除术(MC),观察组予以LC术,比较两组手术一般情况、手术前后血清CCK-A、SREBP-2、TCB、疼痛(简化McGill疼痛问卷)、并发症发生率。结果观察组手术时间、术后住院时间、肠鸣音复常时间、下地活动时间均短于对照组,术中出血量较对照组低(P<0.05);观察组术后CCK-A水平高于对照组,SREBP-2、TCB低于对照组(P<0.05);观察组术后1、3、7 d McGill评分低于对照组(P<0.05),术后1个月内并发症发生率低于对照组(P<0.05)。结论与MC术相比,LC术治疗胆结石疗效更好,可有效促进患者术后恢复,提高CCK-A水平,下调SREBP-2、TCB及炎症因子水平,降低疼痛和并发症风险,值得临床推广实践。
