摘要
胆囊收缩素(CCK)是小肠上部肠内分泌I细胞产生的一种重要的神经肠肽激素。富含蛋白质和脂肪的食物在触发肠道CCK分泌中起着重要作用。碳水化合物仅刺激少量的CCK释放。 CCK-1受体(CCK-1R)主要位于胆囊,Oddi括约肌,胰腺,小肠,胃粘膜和幽门括约肌,在其中它负责CCK调节多种消化过程,包括胆囊收缩,胰腺分泌,小肠运输和胃排空。积累的证据清楚地表明,CCK通过CCK-1R信号级联反应调节胆囊和小肠运动,而CCK-1R对小肠运输的作用是调节肠内胆固醇吸收的生理反应。破坏小鼠中的Cck或Cck-1r基因可通过破坏胆囊排空和胆汁胆固醇代谢,以及促进肠道对胆固醇的吸收,显着增加胆固醇胆结石的形成。主要在胆固醇胆结石患者中发现对外源性给予的CCK有反应的胆囊运动功能异常。色素性胆结石患者表现出中等程度的胆囊运动性缺陷,无胆囊炎症和空腹胆囊肿大。尽管未观察到胆结石,但已在几种情况下发现功能失调的胆囊收缩力,例如怀孕,肥胖,糖尿病,腹腔疾病和全胃肠外营养。胆囊特异性CCK-1R选择性激动剂可能会导致一种有效的新颖方法,通过促进胆囊排空来预防胆结石形成,特别是对于孕妇和胆囊运动功能障碍的受试者,例如乳糜泻患者以及全肠外营养患者。
关键词: 胆汁盐,胆汁淤泥,胆固醇结晶,胆囊运动,石质胆汁,胆囊收缩素(CCK)。
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