How is bilirubin calcium stone to return a responsibility?
summary
In addition to bilirubin, calcium bilirubinate and organic matter (bacteria, eggs or epithelial cells) are the main components of calcium bilirubinate stones. Stones may exist in the common bile duct or in the intrahepatic and extrahepatic bile duct system, but rarely in the gallbladder. So how is bilirubin calcium stone to return a responsibility?
How is bilirubin calcium stone to return a responsibility?
Infection: biliary tract infection is the main cause of calcium bilirubinate stone formation. Bacteria in the bile duct are released during infection β- Glucuronidase hydrolyzes conjugated bilirubin to produce glucuronic acid, and its free bilirubin combines with calcium salt to precipitate. Under normal circumstances, although bile contains β- Glucuronidase, but the content of glucuronidase is relatively small. At the same time, there are glucose 1,4-spironolactone and other conjugates, so it does not show the activity of glucuronidase. But when biliary tract infection occurs, it is not only in bile β- The activity of glucuronidase was increased, and the infection of Escherichia coli, Bacteroides and Clostridium could produce a large amount of glucuronidase β- Glucuronidase. such β- With the increase of glucuronidase content and activity, a large amount of conjugated bilirubin can be hydrolyzed to form free bilirubin, which is insoluble in water and combines with calcium in bile to form insoluble calcium bilirubin particles. The core of calcium bilirubinate granules is exfoliated erythrocytes and parasite eggs. With the help of mucin in bile, calcium bilirubinate granules continuously deposit to form stones.
Biliary ascariasis: biliary ascariasis is the main cause of bile duct stones in China. In addition, clonorchiasis and flagellatosis can also cause bile duct injury and infection. In addition, the residual body and egg of the worm can form the stone core, which is the condition for the formation of primary bile duct stones. Bile composition changes: bile acid can prevent or reduce the precipitation of calcium bilirubin, and glycoprotein can easily become the scaffold of stones.
Oxygen free radical: oxygen free radical can accelerate the formation of calcium bilirubin, and make gallbladder epithelial cells secrete more glycoprotein, which is conducive to the formation of gallstones. Diet: long term malnutrition can not only affect the normal defense ability of biliary tract, but also reduce and inhibit the production of glucocorticoid in bile by low-fat, low protein and high carbohydrate diet β- The effect of glucuronidase was weakened, β- The activity of glucuronidase is enhanced, and bilirubin precipitation is easy to form pigment gallstones. Congenital abnormality of biliary system: the obstruction of biliary flow caused by anatomical variation of biliary system is easy to cause gallstones in this part. It should be noted that malnutrition is common in patients with pigment gallstones.
matters needing attention
The characteristics of calcium bilirubinate stones are: the stones are sandy or massive, and some large stones have the same shape as the dilated bile duct. Most of the stones are brown yellow or brown black, loose and fragile. The occurrence of calculus is closely related to diet structure, health habits, biliary tract infection and biliary Ascaris. The incidence rate of young adults is high, and some clinical symptoms can be traced back to childhood. The disease is chronic and progressive, seriously endangering the health of the working people. The treatment of calcium bilirubinate stone is mainly to actively treat its primary disease, such as deworming, anti infection, improving diet, strengthening nutrition and so on.
