血清ビリルビン抱合体分析による先天性胆道閉鎖症の鑑別 : 臨床例と疾患モデルラットの比較

概要

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Detection of the bilirubin conjugate "C", the major bilirubin conjugate, in the serum by means of HPLC is significant to differentiate CBA (congenital bile duct atresia) from other neonatal jaundice. The present studies have been performed to ascertain availability of this method on serum specimens of newborn babies with jaundice and of rats with experimental model of cholestasis. CBA babies within two months of age have a plasma bilirubin conjugate pattern of diglucuronide/conjugate "C" ratio (DG/"C") below one, while these beyond two months of age showed DG/"C" above one. The DG/"C" ratio was also above one in the serum of babies with congenital intrahepatic cholestasis. The DG/"C" ratio was below one in rats with complete bile duct obstruction, while the ratio was above one in rats with incomplete bile duct obstruction, ANIT-induced cholestasis, and d-galactosamine-induced liver injury. These results in newborn babies and rats with experimental model of cholestasis seemed to coincide with each other, and the characteristic finding is that the DG/"C" ratio below one is observed only in CBA babies below two months of age and rats with complete bile duct obstruction within 48 hours after operation. It was concluded, therefore, that determination of DG/"C" ratio in serum by means of HPLC is useful to differentiate CBA babies within two months of age from others with neonatal jaundice of various etiologies.
日本小児外科学会の論文
1983-02-20