胆囊结石是消化系统的常见病、多发病,其中以胆固醇性结石最为多见,目前胆固醇结石的发生机制仍十分复 杂,涉及胆固醇代谢、胆囊功能、肠道菌群、环境与遗传等多个方面,如何防治胆固醇结石成为临床研究的热点和难点。 有研 究发现补充亲水性胆汁酸类药物可预防和治疗部分胆囊结石,说明胆汁酸在胆囊结石的发生、发展过程中起着重要作用。 胆 汁酸是胆汁中重要的组成部分,它不仅参与人体脂质的消化吸收,同时作为胆固醇的代谢产物之一,对维持胆汁中胆固醇稳 定和防止胆固醇结石形成具有重要意义。 正常情况下,胆汁中胆固醇、磷脂、胆汁酸等 3 种有机成分保持着合理的比例,使胆 固醇结晶不易沉积形成结石,而当胆汁酸的合成分泌、转运、摄取和重吸收等环节失调,均会导致胆汁酸池减少,胆汁稳态失 衡,使胆固醇过饱和析出导致结石形成。 此外,胆汁酸代谢紊乱,还会进一步导致胆囊功能障碍、肠道菌群失调从而加速胆固 醇结石的形成。 为进一步认识上述机制间的内在联系,现就胆汁酸代谢与胆固醇结石发病机制之间的关系及最新研究进展 进行综述。

Gallstones are a common and frequently occurring digestive disease with cholesterol stones being the most prevalent type. Intestinal flora gallbladder function environment genetics and cholesterol metabolism are just a few of the factors that play a role in the mechanism of cholesterol stones at this time. Clinical research on how to prevent and treat cholesterol stones has become a hot topic and challenge. According to some studies hydrophilic bile acid drugs can help prevent and treat some gallstones proving that bile acid is a key factor in the formation of gallstones. It is not only a crucial component of bile that aids in the breakdown and absorption of human lipids but it is also one of the cholesterol's metabolites. The stability of cholesterol in bile must be maintained in order to avoid cholesterol stones from developing. In bile cholesterol phospholipid bile acid and other organic components typically remain in a reasonable ratio preventing cholesterol crystals from easily depositing and forming stones. However when bile acid synthesis secretion transport uptake and reabsorption are abnormal bile acid pool will be reduced bile homeostasis is unbalanced and cholesterol oversaturation will precipitate and cause stone formation. In addition bile acid metabolism problems will worsen gallbladder problems alter intestinal flora and hasten the development of cholesterol stones. This paper reviews the relationship between bile acid metabolism and the pathogenesis of cholesterol stones and the most recent advances in research in order to better understand the internal relationship between the aforementioned mechanisms.