bsep mrp2 fxr在肝硬化合并胆囊结石患者 肝脏的表达及其意义word格式论文.docxVIP

目录中文摘要···············································································1英文摘要·················································································3英文缩写················································································6研究论文BSEP、MRP2、FXR在肝硬化合并胆囊结石患者肝脏的表达及其意义前言················································································7材料与方法····································································8结果·········································································12附图···············································································14附表···············································································20讨论···············································································22结论···············································································26参考文献········································································27综述肝硬化易发胆囊结石的发病机制········································30致谢·····················································································42个人简历···············································································43BSEP、MRP2、FXR在肝硬化合并胆囊结石患者肝脏的表达及其意义摘要目的：肝硬化患者胆囊结石发病率较正常人高约3倍，常因合并手术禁忌症导致治疗困难。胆汁酸代谢异常可能为肝硬化患者易发胆囊结石的主要原因之一，而胆盐转运蛋白（BSEP、MRP2）在其中起重要作用。本实验通过研究肝硬化合并胆囊结石患者较单纯胆囊结石患者肝脏BSEP、MRP2及其调控因子FXR的表达，结合血清生化指标的水平，探讨肝硬化患者胆汁酸代谢异常在胆囊结石形成中的作用。方法：1符合入组标准的肝硬化合并胆囊结石患者10例，单纯胆囊结石病人18例，所有患者术前均行肝胆超声明确患有胆囊结石，肝硬化组患者术后病理证实为肝硬化。所有患者均于术前1天采血检测血总胆红素、直接胆红素、胆固醇、甘油三酯及总胆汁酸。术中获取肝组织标本，获取的肝组织保存于福尔马林液中并于1天内制成石蜡切片。2石蜡标本采用免疫组织化学方法（SP法）：分别检测FXR、BSEP、MRP2 在肝脏组织的表达，采集图片后进行免疫组画图像评分。3统计学处理：采用SPSS16.0软件对结果进行分析，根据分析对象的不同采用t检验、t＇检验以及秩和检验，并进行相关性分析；检验标准以P0.05为有统计学意义。结果：1生化指标测定：尚不能认为肝硬化合并胆囊结石组血总胆红素水平之间存在差异（P0.05），肝硬化合并胆囊结石组血直接胆红素水平明显高于单纯胆囊结石组（P0.05），差异有统计学意义，肝硬化合并胆囊结石组血胆固醇明显低于单纯胆囊结石组（P0.05），差异有统计学意义，肝硬化合并胆囊结石组血甘油三酯明显低于单纯胆囊结石组（P0.05），差异有统计学意义，肝硬化合并胆囊结石组血总胆汁酸明显高于单纯胆囊结石组（P0.05），差异有统计学意义；2肝脏HE染色观察结果及FXR、MRP2、BSEP的免疫组织化学方法观察结果、评分：肝硬化合并胆囊结石组病理组织可见局部肝细胞水肿、脂肪变性，结缔组织增生、炎细胞浸润，FXR、BS