田卫军 俞生 赵玉文 姜元宝 龙成科 余小华

[摘要] 目的 通過建立肠肝循环模型及阻断肠肝循环，研究家兔胆固醇肠肝循环的存在及其显著性。 方法 本实验设置实验组与对照组，进行高胆固醇饮食与普通饮食差异饲养，通过建立肠肝循环模型及阻断肠肝循环，利用胆固醇氧化酶法分别测定实验组与对照组血清胆固醇浓度，通过6个月数据统计分析，研究胆固醇的肠肝循环现象。 结果 通过6个月数据统计，A、C两组家兔血清胆固醇浓度逐步上升，C组家兔后两个月高胆固醇血症表现明显，A组家兔血清胆固醇浓度上升幅度较C组弱，高胆固醇血症表现不明显，A组与C组比较差异有统计学意义（P<0.05）；D组家兔血清胆固醇浓度稍有上升，但上升幅度不明显，B组血清胆固醇浓度上升幅度较D组明显，B组与D组比较差异有统计学意义（P<0.05）。以每组家兔血清胆固醇浓度为纵坐标，以时间为横坐标，绘制血清TC-时间线状图，C组较A组家兔血清胆固醇上升趋势明显，B组较D组家兔血清胆固醇上升趋势明显。 结论 家兔胆固醇肠肝循环现象存在，通过阻断家兔肠肝循环，对降低家兔血清胆固醇含量具有一定作用，从而为进一步研究阻断肠肝循环降低人体胆固醇含量提供理论基础，为临床上通过阻断胆固醇肠肝循环途径治疗高胆固醇血症提供新思路，为药品研发指引方向。

[关键词] 高血脂；高胆固醇血症；胆固醇；肠肝循环

[中图分类号] R96 [文献标识码] A [文章编号] 1673-9701（2018）15-0034-03

Study on the effect of enterohepatic circulation on cholesterol excretion in rabbits

TIAN Weijun1 YU Sheng1 ZHAO Yuwen2 JIANG Yuanbao1 LONG Chengke1 YU Xiaohua3

1.Emergency Center， Shannan Peoples Hospital in Tibet Autonomous Region， Shannan 856000， China； 2.Huaibei Miner General Hospital Group， Huaibei 235000， China； 3.Department of Vasculocardiology， Shannan Peoples Hospital in Tibet Autonomous Region， Shannan 856000， China

[Abstract] Objective To study the existence and significance of cholesterol-intestinal hepatic circulation in rabbits by establishing a model of enterohepatic circulation and blocking enterohepatic circulation. Methods In this experiment， the experimental group and the control group were set up to conduct high-cholesterol diets and ordinary diets for differential feeding. By establishing a model of enterohepatic circulation and blocking enterohepatic circulation， cholesterol oxidase method was used to measure serum cholesterol concentration in the experimental group and the control group respectively. Based on the statistical analysis of the data for 6 months， the phenomenon of enterohepatic circulation of cholesterol was studied. Results Based on the data of 6 months， the serum cholesterol concentrations of rabbits in groups A and C were gradually increased. After two months， the hypercholesterolemia was significant in the rabbits in group C. The increase degree of serum cholesterol concentration in the rabbits in group A was weaker than that in group C. Hypercholesterolemia had no obvious effect. There was statistically significant difference between group A and group C （P<0.05）； serum cholesterol concentration in rabbits in group D was increased slightly， but the increase was not significant. The increase of serum cholesterol concentration in group B was more significant than that of group D. There was a statistically significant difference between group B and group D（P<0.05）. The serum TC-time line graph was plotted with the serum cholesterol concentration in each group as the ordinate and the time as the abscissa. Compared with group A， the serum cholesterol was increased significantly in group C. Compared with group D， the serum cholesterol in group B was increased significantly. Conclusion This experiment shows that the cholesterol enterohepatic circulation phenomenon exists in rabbits. By blocking the enterohepatic circulation in rabbits， it has a certain effect on lowering the content of serum cholesterol in rabbits. This will provide a theoretical basis for further studying the role of blocking enterohepatic circulation in reducing cholesterol levels in the body. It provides new ideas for the clinical treatment of hypercholesterolemia by blocking the cholesterol enterohepatic circulation in clinical practice and points a direction for drug development.

[Key words] Hyperlipidemia； Hypercholesterolemia； Cholesterol； Enterohepatic circulation

被分泌到胆汁内的药物及其代谢产物经由胆道及胆总管进入肠腔，经胆汁排入肠腔的药物部分可再经小肠上皮细胞吸收经肝脏进入血液循环，这种肝脏、胆汁、小肠间的循环称肠肝循环（enteroheptic cycle，ETC）。肠肝循环是体内一种特殊生理现象，药物ETC现象在临床上具有不同的意义，药物ETC的存在可使药物出现双峰或多峰现象，有助于提高药物的生物利用度，内源性物质和毒性物质ETC现象则使人体长时间蓄积而带来危害。阻断肠肝循环（interruption of enterohepatic circulation，IETC）就是阻断具有ETC特性物质在肠道内的重吸收过程，使其ETC过程受到抑制，降低药物在人体内负荷的原理。

本实验运用家兔作为实验对象，通过建立肠肝循环模型及阻断肠肝循环，研究胆固醇肠肝循环的存在及其显著性，从而为临床上通过阻断胆固醇肠肝循环途径治疗高胆固醇血症及药品研发提供理论基础和现实依据。……