肝疾患における胆汁酸分画測定の臨床的意義--劇症肝炎および急性肝炎における血中胆汁酸構成

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We studied individual bile acids in 9 patients with fluminant hepatitis (FH) and 12 patients with acute hepatitis (AH) using high performance liquid chromatography and immobilized 3α-hydroxysteroid dehydrogenase in column form (by OKUYAMA 1979). 1) There were no difference in total bile acids (TBA), conjugation rate and glycine-conjugated bile acid/taurine-conjugated bile acid ratio (G/T ratio) between FH and AH. 2) Percentage of glycocholic acid, taurocholic acid and cholic acid to TBA were significantly higher in AH than in FH (P<0.05). Glycocholic acid/glycochenodeoxycholic acid ratio (GC/GCDC ratio), taurocholic acid/taurochenodeoxycholic acid ratio (TC/TCDC ratio) and cholic acid/chenodeoxycholic acid ratio (C/CDC ratio) were significantly higher in AH than in FH, too (P<0.05). 3) Percentage of cholic acid and chenodeoxycholic acid to TBA and C/CDC ratio correlated closely with Thrombotest (TT), Hepaplastintest (HPT) and α2-heat stable glycoprotein (α2-HS) (P<0.01). We concluded that determinations of individual bile acids were more sensitive indicater in diagnosing FH from AH.
社団法人日本肝臓学会の論文