膽汁이 血液凝固에 미치는 影響

Abstract

[한글]

[영문]

Although it has been knwon for many years that the bile salts inhibit the blood coagulation (Takashima, 1933), the underlying mechanism(s) is not yet understood. Since the bile contains many substances, it is of considerable interest to know which constituent of the bile is responsible for this inhibition of blood coagulation. Sterner and Medes have already shown in 1936 that taurocholic acid, a main bile salt in the dog, inhibits the process of blood coagulation. However, whether other constituents of the bile than taurocholate are also involved in this action is not established. Hence, this investigation was undertaken to study how the bile inhibits the blood coagulation.

The bile samples were obtained from the gall bladder as well as from the common bile duct of human and the dog, and the effect on the coagulation of rabbit's blood was studied. The gall bladder bile inhibited blood clotting so strongly that no clotting was observed within 24 hrs. Although the hepatic bile showed a similar action, the extent of inhibition was much weaker than that of the gall bladder bile. On the other hand, the white bile obtained from a patient had no effect on blood clotting. On the basis of these findings, it was thought that either bilirubin or cholate in bile is responsbile for delaying blood clotting. However, bilirubin had no effect while taurocholate or desoxycholate delayed blood clotting considerably, indicating that cholate is responsible for the anticoagulant action of bile. Further studies indicated that taurocholate has strong antithrombin as well as antiprothrombin activities. However, the fibrinolytic activity of taurocholate was not detected. On the basis of these results, it is concluded that bile salts are responsible for delaying blood clotting by counteracting the activities of thrombin and prothrombin.