Bacterial cultures and β-glucuronidase activity of bile were studied in 64 patients with gallstones. In the gallbladder stones, the activity of β-glucuronidase in bile was 109±59.23 mcg/dl if infected with E. coil, and 1.82±0.5 in bile without bacterial infection.
The activity of 3-glucuroñidase was high in bile, 82.45±41.05mcg/dl for mixed infection of E. coil and Bacteroides, it was 31.24±7.46 mcg/dl for single infection of E. coil in the patients of common bile duct stones. But in the intrahepatic stones, the activity was 87.33±30.34mcg/dl for infection of both E. coli and Bacteroides, and 79.71±20.95mcg/dl for single infection of B. coil alone. The activity of β-glucuronidase in bile were 23.67±22.18 and 19.43±8.11 mcg/dl for common bile duct stones and intrahepatic stones without bacterial infection respectively. The activity in the bile ductules were also strong in the presence of bacterial infection.
Another 93 bile samples infected with bacteria could be found in 105 patients of intrahepatic stones. Among these, 48E. coli strains were identified and serotyped with OK anti-serum. The most common serotypes of E. coil in bile were O128K67, O127K63, P125K70 and O(subscript 18a18b)K76. The average capability of producing β-glucuronidase was 214.96±70.57 mcg/dl and the positive rate was 95.56% (43/45). Activity of β-glucuronidase was not detectable in the rare strains of O(subscript 20a20b)K61 and O28K73. Moreover, the relation between β-glucuronidase activity and presence of bacteria infection is clear. Hence, the role of bacterial β-glucuronidase has of major significance in the formation of calcium bilirubinate stones. 膽石症與大腸菌之關係早卽被人注意之問題，本研究將探討大腸菌之β-glucuronidase活性值與膽汁合併細菌感染時之膽汁中活性濃度之探討。
共有64例膽石症之病人膽汁細菌培養及膽汁本酵素濃度之測定，在膽囊結石時，有大腸菌感染者時，其β-glucuronidase之濃度為109.3±59.23 mcg/dl，而無感染者其膽汁中濃度甚低。假如膽汁中同時感染大腸菌及厭氧菌時，其總膽管結石之膽汁中之本酵素濃度為82.45±41.05 mcg/dl，只感染大腸菌者為31.24±7.46 mcg/dl，但在肝內結石者如同時感染大腸菌及厭氧菌時則為87.33±30.34 mcg/dl，若只大腸菌感染則為79.71±20.95 mcg/dl，此外在肝細膽管之組織生化學檢查其木酵素程度，如併有細菌感染時，則其肝細膽管之本酵素程度亦強之傾向。
另外從105例肝內結石之膽汁中，93例陽性細菌培養中，有48例為大腸桿菌感染，再以OK抗原將此大腸菌分型及測定β-glucuronidase之活性濃度。結果OK抗原分型以O128K67，O127K63，O125K70及O(下標 18a18b)K76為較常見，而其產生本酵素之平均濃度為214.96±70.57 mcg/dl，陽性率為95.56%(43/45)只有少見之O(下標 20a20b)K61及O28K73大腸菌無法測出本酵素活性。一般言，細菌來之本酵素活性是很高的，所以從細菌來之本酵素與膽石形成關係其有意義的，特別是膽色素鈣石之形成更有密切關係。
關聯:
嘉南學報 15 : p.A61-A67 轉載 The Kaohsiung Journal of Medical Sciences 3(3),p.192-198 (1987)
