胆道閉鎖症の術後黄疸消失例における外因性胆汁酸負荷試験

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Conventional liver function tests do not always show the exact liver function in postoperative biliary atresia (BA) patients. Although bile acid torelance test after oral administration has been employed for diagnosis of various hepatic diseases, it has never been studied in BA patients. Bile acid tolerance test following oral administration of ursodeoxycholic acid (UDCA) was performed in 11 postoperative non-jaundiced BA patients. Blood samples were collected from peripheral veins before and at 30, 60, 120, and 180 min. after administration of UDCA. UDCA and glycine-conjugated UDCA were measured by high performance liquid chromatography and 3α-hydroxysteroid dehydrogenase immobilized in column form. 1) Disappearance curve of UDCA showed a significantly higher level at 30-60 min. in sera of most BA patients as compared with normal infants. 2) Area under curve (AUC) of UDCA which indicated liver capasity to handle the loaded bile acid for a given time showed a significantly higher level in most BA patients than in normal infants. 3) Only 3 in 11 postoperative non-jaundiced BA patients were normal on this bile acid tolerance test. In conclusion, our present study indicated that disturbance in bile acid metabolism existed in most postoperative BA patients who had recovered from jaundice completely and showed normal values on conventional liver function tests. Therefore, bile acid tolerance test can be useful to evaluate the reserved function of the liver in these patients during the long term follow-up period.
日本小児外科学会の論文
1986-06-20

胆道閉鎖症の術後黄疸消失例における外因性胆汁酸負荷試験

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