Clinical significance of bile acid determination in patients with acute hepatic failure.

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In order to clalify the clinical significance of serum bile acid examination in acute hepatic failure, serum total bile acid and its subfraction were studied in such patients. Changes of these items were evaluated in each survival and non-survival cases.<BR>Subjectes were 11 patients with acute hepatic failure (fulminant hepatitis 9 and subacute hepatitis 2 cases). All patients were treated with glucagon and insulin. In 8 patients, plasma exchanges were also performed from one to 12 times. As for prognosis 3 patients survived and 8 patients died. B type hepatitis was seen in 6 cases, NANB was 4 cases and one was drug induced hepatic injury.<BR>In survival cases levels of TBA decreased step by step after repeated plasma exchanges. A ratio of CA/CDCA increased clearly in survival cases during their clinical course. CA/CDCA ratio had a good correlation with prothrombin time and hepaplastin test. Therefore, it seems that this parameter is very useful in consideration of the prognosis in the patients with acute hepatic failure.
社団法人日本肝臓学会の論文