<原著>血清ビリルビン分画の臨床的意義
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概要
- 論文の詳細を見る
Serum bilirubin was fractionated by a newly developed reversed phase high performance liquid chromatography (HPLC), on Micronex RP-30. In patients with jaundice, five peaks (δ, γ, β, β' and α in the elution order) were obtained by the HPLC. These five peaks were diazotized and studied by using thin layer chromatography, and they were confirmed as follows : δ (δ bilirubin, Bδ), γ (bilirubin diglucuronide, BDG), β (bilirubin monoglucuronide, BMG), β'((Z, E)- and/or (E, Z)- bilirubin IXα), and α ((Z, Z)-bilirubin IXα). The correlation between the data obtained by this method and by the former methods (Lauff's method, dry chemistry method, Jendrassik-Grof method) was good in patients with conjugated hyperbilirubinemia. However, in patients with low total serum bilirubin concentration, in healthy adults and in patients with unconjugated hyperbilirubinemia, the correlation was poor. This method was more sensitive than the previous methods in the detection of conjugated bilirubins. In addition, this method involves a simple pretreatment of serum samples, in contrast with the complex preparation described by the Lauff's method. In the results of this fractionation of serum bilirubin in 187 patients with various hepatobiliary diseases, the ratio of Bδ/(Bδ+BDG+BMG) was significantly lower during the progressing phase of jaundice than during the convalescent phase, and the ratio of BMG/Bδ showed the opposite trend. Thus the pathophysiological status of patients with jaundice could be more clearly understood through the analysis by the HPLC reported here than the Jendrassik-Grof method using diazo reaction. In addition, the photoderivatives of bilirubin such as β' fraction could be quantified by the same procedure, which implies that the fractionation may be used to evaluate the effect of phototherapy on neonatal jaundice.
- 近畿大学の論文
- 1989-03-25