Цель. Изучение роли факторов риска в механизмах желчного камнеобразования в зависимости от пола и возраста пациентов.Материал и методы. Обследованы 210 пациентов с I стадией желчнокаменной болезни (ЖКБ). В верификации диагноза использованы ре-зультаты ультразвукового исследования гепатобилиарной системы, многофракционного дуоденального зондирования с последующим ма-кроскопическим, микроскопическим, химическим и физическим исследованием желчи. В порциях «В» и «С» желчи определялась суммарная концентрация желчных кислот, холестерина, с последующим вычислением холатохолестеринового коэффициента. Проведено определение поверхностного натяжения желчи и вязкости желчи. В крови изучено содержание общего холестерина, липопротеидов очень низкой плотно-сти, липопротеидов низкой плотности, липопротеидов высокой плотности, триглицеридов, определялся коэффициент атерогенности. В оцен-ке степени накопления жировой массы тела использовался индекс Кетле. Изучен относительный риск анамнестических факторов риска ЖКБ. Заключение. Полученные данные могут быть использованы в организации диспансерной работы с больными гепатобилиарной патоло-гией и в оптимизации первичной профилактики желчного камнеобразования. Ключевые слова: факторы риска желчного камнеобразования, литогенная желчь, возрастно-половые особенности холецистолитиаза AbstractGoal. Study of the role of risk factors in mechanized gall stone formation depending on sex and age of patients. Material and methodsWe examined 210 patients with stage I gallstone disease (GSD). In verification of diagnosis used an ultrasound study of the hepatobiliary system, multi-grade duodenal sounding with subsequent macroscopic, microscopic, chemical and physical examination of bile. In the portions "b" and "C" bile was determined the total concentration of bile acids, cholesterol, with the subsequent calculation it consists of cholesterol ratio. Estimation of surface tension of bile viscosity and bile. In the studied blood levels of total cholesterol, lipoproteins of very low density, lowdensity lipoproteins, high density lipoproteins, triglycerides, were determined the coefficient of atherogenicity. To assess the degree of accumulation of body fat was used the Quetelet index. Studied the relative risk of anamnestic risk factors of GSD.Results. The features of biliary lithogenesis based on gender and age of patients. High value PR for the gall stone formation are female gender -3,16, Mature and elderly age (older than 50) of 3.67. In young women, gall-stone formation is mainly due to the increase of cholesterol level of bile, at the age of 50 years with a decline in zhelchnokamennaja pool, increased viscosity and surface tension of bile.The most important risk factors of cholecystolithiasis are also gender differences: if women is multiple pregnancies and (or) childbirth (more than 3) -OR 4,62, overweight (BMI over 26) -OR is 4.57 and the violation of the principles of good nutrition (eating disorders, overeating or starvation, the use of large quantities of animal fats) -OR 3,94, for men it's...
The aim. Find out the nature of the changes of the hepatobiliary system in patients with intestinal bacterial overgrowth and study the possible mechanisms of their association.Materials and methods. 148 patients with intestinal bacterial overgrowth and intestinal dysbiosis were examined. The level of total cholesterol, cholestasis and cytolysis markers was determined in the blood using the analyzer «Labsystems» (Finland). Intestinal bacterial overgrowth syndrome was assessed using a hydrogen breath test with lactulose on the LactophaH2 apparatus of AMA (St. Petersburg). Intestinal dysbiosis was determined by plating feces on nutrient media. Bile acids in bile were determined on the AmazonX mass spectrometer (Bruker Daltonik GmbH, Bremen, Germany). Ultrasound examination of the abdominal cavity performed with the apparatus «SHIMADZU SDN-500» (Japan). Liver elastography was performed using the AIXPLORER apparatus (France).Results. The syndrome of intestinal bacterial overgrowth in 67% of cases was established in the presence of ileocecal insufficiency, in 33% of cases — with preserved ileocecal function. The combination of intestinal bacterial overgrowth syndrome and intestinal dysbiosis was detected in 81,8% of patients. The majority of the examined patients showed clinical symptoms of damage the hepatobiliary system and intestines, which was confirmed by change laboratory parameters — increase the level of total cholesterol, markers of cholestasis and cytolysis compared with the control group. In the study of bile acids in bile, decrease free (mainlycholic) and increase conjugated (glycodesoxycholic, taurodesoxycholic, glycocholic, taurocholic) bile acids was observed compared with the control group. In general, patients with the syndrome of intestinal bacterial overgrowth revealed the presence of non-calculous cholecystitis — in 11,5% of cases, I stage of cholelithiasis — in 25,7%, II stage of cholelithiasis — in 18,9%, non-alcoholic fatty liver disease on stage steatosis and steatohepatitis — in 43,9% of cases.Conclusion. Intestinal bacterial overgrowth syndrome is the beginning of bacterial translocation, which is the triggering factor in inflammation of the liver and biliary tract. In turn, diseases of the hepatobiliary system contribute to the development of intestinal dysbiosis by reducing the synthesis of bile acids with antibacterial action, as well as violations of their excretion. Thus, strong association of intestinal bacterial overgrowth syndrome with damage to the hepatobiliary system has been established.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.