Igarashi Y, Ishiyama S, Urayama M, Kuzu H, Fuse A, Tsukamoto M
The First Department of Surgery, Yamagata University, Yamagata, Japan.
J Surg Res. 1999 Mar;82(1):67-72. doi: 10.1006/jsre.1998.5516.
Bilirubin metabolism after major hepatectomy was investigated experimentally using rats. After a 70% and an 80% hepatectomy, proportions of bilirubin diglucuronide (BDG) decreased, and reversely, those of bilirubin monoglucuronide (BMG) increased. These changes were even more remarkable after an 80% hepatectomy. Parallel to the decrease in the proportions of BDG, the concentrations of uridine diphosphoglucuronic acid (UDP-GA) in the remnant liver decreased, and there was a significant correlation between the changes in BDG and UDP-GA. Although UDP-glucuronyltransferase (UDP-GT) activity and energy charge of the remnant liver also decreased after surgery, these decreases were mild and returned to the control level earlier than BDG. And there was no significant correlation between the changes in BDG and those in UDP-GT activity and energy charge. In this study, the decrease of the proportions of BDG in the bile juice was long term after partial hepatectomy and the period of the decrease became longer according to the augmentation of the volume of the hepatectomized liver. We clarified that the process of the UDP-GA production was inhibited after hepatectomy and the decrease of the proportions of BDG was derived from a deficiency of substrate of the glucuronidation, UDP-GA.
利用大鼠对大肝切除术后的胆红素代谢进行了实验研究。在进行70%和80%肝切除术后，胆红素二葡萄糖醛酸酯（BDG）的比例降低，相反，胆红素单葡萄糖醛酸酯（BMG）的比例升高。在80%肝切除术后，这些变化更为显著。与BDG比例降低平行，残余肝脏中尿苷二磷酸葡萄糖醛酸（UDP-GA）的浓度降低，并且BDG和UDP-GA的变化之间存在显著相关性。尽管术后残余肝脏的UDP-葡萄糖醛酸基转移酶（UDP-GT）活性和能荷也降低，但这些降低程度较轻，且比BDG更早恢复到对照水平。并且BDG的变化与UDP-GT活性和能荷的变化之间没有显著相关性。在本研究中，部分肝切除术后胆汁中BDG比例的降低是长期的，并且根据肝切除肝脏体积的增加，降低的持续时间变长。我们阐明了肝切除术后UDP-GA的产生过程受到抑制，并且BDG比例的降低源于葡萄糖醛酸化底物UDP-GA的缺乏。
