Infrared spectrophotometry을 이용한 담석 분석

Abstract

[한글]

담석 분석은 1863년 Thudichum이 최초로 담석의 외형적상태에 따라 분류한 이레 여러번의 수정을 거쳐왔다. 담석의 분석은 그 성분이 담즙색소와 무기질을 함유하고 있기 때문에 어려운 점이 많다. 분석방법으로는 Stepwise solvent extraction method, X-ray diffr

action method, thin layer chromatography, 그리고 Infrared spectrophotometry absorption spectra등의 여러 방법들이 있으며 각 방법들은 각각 장점을 가지고 있으나 어느 것이나 완전하지는 뭇하다.

Infrared spectrophotometry method는 결정성이나 용해성에 관계없이 비교적 모든 성분을 분석할 수 있으나 정확한 정량분석은 불가능한 단점이 있다. 또한 시약의 종류에 따라 Nujol method와 KBr mothod가 있으나 Nujol method는 시약 자체의 파장이 담석성분의 특이파장과 혼돈 될 수 있기 때문에 KBr method가 많이 사용되고 있다.

이에 저자들은 1980년 7월1일부터 1981년 4월30일까지 연세의료원 외과학교실에서 담석증으로, 수술을 시행하여 담석이 확인된 환자 100명에서 얻은 담석을 중심으로 Perkin-Elmer사 제품인 Infrared spectrophotometry을 사용하여 KBr method로 분석하였으며, 이미

알려진 각 성분의 특이파장을 통하여 분석하였다.

담석분류는 Haruo Kameda & Goro Chihara등의 분류법을 사용하였다.

1) 담석은 40∼50대에 60%이상 발생하고 여자에 1.4배 많이 발생한다.

2) Cholesterol이 주성분인 경우 47%, Bilirubin이 주성분인 경우 45%, 그리고 Calcium carbonate담석도 6% 있었다.

3) Calcium bilirubinate담석이 cholesterol 담석에 비하여 여자에 많이 발생하였다.

4) 40세 이하는 cholesterol 담석이 60%인 반면, 40세 이상에서는 calcium biliribinate 담석이 52% 정도 차지하였다.

5) 담낭내 담석은 cholesterol 담석이 62.2%인 반면, 총수담관과 간내담석은 calcium bilirubinate 담석이 67%, 93%를 차지하였다.

6) 거대담석 15예를 분석한 바 내부와 외부사이에 현저한 차이가 없었으며, 다발성 담석 19예중 3예를 제외하고는 유사한 성분을 보여주었다.

[영문]

The first recorder of gallstone analysis is well summarized in Thudichum's notable monography "Treatise on gallstones" in 1863. The analysis of gallstones always presented a problem because of the presence of bile pigment and inorganic compounds. Various methods have been proposed including stepwise solvent extraction, X-ray diffraction analysis, thin-layer chromatography, gas chromatography and infrared spectrophotometry. These methods are complementary to each other but not complete themselves alone. The intoduction of solid state analytical techniques, such as infrared spectrophotometry and X-ray diffraction have permitted identification of insoluble components of gallstones. By X-ray

diffraction techniques, gallstones have been classified by their crystalline organic and inorganic components. Unfortunately, 50 per cent of gallstones are non-crystalline (amorphous) and can not be analyzed by this method. By infrared spectrophotometry method, requiring neither gallstone crystallity nor solubilization, almost every components can be analyzed. In infrared spectrophotometry, there are two different methods, Nujol method and potassium bromide method as reagent. In Nujol method, the specific wave of reagent and specific wave of gallstone components can be confused. So, potassium bromide method was recommended recently.

100 patients, who were operated for gallstone, were used in this study. All of them were operated from July, 1980 to April, 1981. Each stones were analysed by infrared spectrophotometry, Perkin-Elmer Co.. and read according to previous known specific wave of components. In classification of gallstone, we used Haruo Kameda & Goro Chihara's method.

1) In this series, gallstones were found more frequently in women (M:F = 1:1.4) and a preponderance was noted particularly with calcium bilirubinate stones. The age incidence of patients was prevalent in the 4th to 5th decade, 61%.

2) Gholesterol stones made up 47 per cent of the total and calcium bilirubinate stones 45 per cent which indicated an increase in the incidence of cholersterol stones compared with previous Korean data.

3) The incidence of cholesterol stones were especially high in below 40 years group and those over 41 years group showed as high rate in calcium bilirubinate stones.

4) Gallstones were found more frequently in the gallbladder, 60.7%. Cholesterol stones were high especially in gallbladder, 62.2 per cent and calcium bilirubinate stones were high in common bile and intrahepatic duct, 67 per cent and 93 per cent accordingly.

5) In giant gallstone, there was no remarkable difference of components between inner and outer layer of gallstone.