閉塞性黄疸時のビリルビン代謝--とくにbilirubin monoglucuronideの変動を中心に

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Clinical and experinental studies have been made to elucidate the mechanism of an increase in amount of serum bilirubin monoglucuronide (BMG) in patients with obstructive jaundice.<BR>In clinical cases, serum BMG was 46.9% of total serum bilirubin in complete obstruciton, 28.0% in acute viral hepatitis and 44.6% in acute intrahepatic cholestasis and the ratio of the amount of BMG to that of bilirubin diglucuronide (BMG/BDG) was 1.46 in complete obstruction. Four days after an operation PTCD in patients with obstructive jaundice, serum BMG decreased to approximatery one third amoullt of its initial varue (46.9±5.0% of total bilirubin).<BR>In experiments with bile duct-ligated rats, an increase of serum BMG was also observed and BMG/BDG ratio inlcreased from 1.39±0.27 to 1.94±0.06 from days after the ligation.<BR>Both β-glucuronidase activity in serum and that in the liver tissue amounted to their maximums on the four days after the ligation and BMG/BDG ratio in serum amounted to their maxinums at the same time.<BR>It is therefore concluded that the increase of BMG in serum of the patients with obstructive jaundiceis mainly due to intrahepatic deconjugation of BDG by increased β-glucuronidase activity in the liver.
社団法人日本肝臓学会の論文