Felsher B F, Carpio N M
Gastroenterology. 1979 Feb;76(2):248-52.
The authors studied 12 patients with chronic persistent hepatitis and persistent or intermittent mild unconjugated hyperbilirubinemia. Maximum serum total bilirubin concentration ranged from 2.1 to 3.6 mg/dl. Hemolysis was not evident. Hepatic bilirubin UDP-glucuronyltransferase activity assayed in each patient ranged from 0.16 to 0.39 U (mean +/- SEM = 0.27 +/- 0.02) compared to 0.68-1.99 (1.35 +/- 0.08) in 23 normals, 0.78-2.28 (1.41 +/- 0.05) in 53 patients with acute hepatitis, 0.34-1.74 (0.81 +/- 0.09) in 16 patients with anicteric chronic persistent hepatitis, and 0-0.62 (0.24 +/- 0.03) in 33 patients with Gilbert's syndrome. The mean UDP-glucuronyltransferase activity was significantly lower in anicteric chronic persistent hepatitis compared to normals, but higher than in Gilbert's syndrome. The incidence of unconjugated hyperbilirubinemia among first degree relatives was 0:32 in icteric chronic persistent hepatitis compared to 24:85 (28%) in Gilbert's syndrome. These results show that the likely cause for the unconjugated hyperbilirubinemia associated with chronic persistent hepatitis is an acquired depression of hepatic bilirubin UDP-glucuronyltransferase activity. The data suggest that the enzyme defect is related to chronic persistent hepatitis.
作者研究了12例慢性持续性肝炎患者，这些患者存在持续性或间歇性轻度非结合胆红素血症。血清总胆红素最高浓度范围为2.1至3.6mg/dl。溶血不明显。每位患者肝脏胆红素UDP-葡萄糖醛酸基转移酶活性范围为0.16至0.39U（均值±标准误=0.27±0.02），而23名正常人为0.68 - 1.99（1.35±0.08），53例急性肝炎患者为0.78 - 2.28（1.41±0.05），16例无黄疸慢性持续性肝炎患者为0.34 - 1.74（0.81±0.09），33例吉尔伯特综合征患者为0 - 0.62（0.24±0.03）。无黄疸慢性持续性肝炎患者的平均UDP-葡萄糖醛酸基转移酶活性与正常人相比显著降低，但高于吉尔伯特综合征患者。黄疸型慢性持续性肝炎患者一级亲属中非结合胆红素血症的发生率为0:32，而吉尔伯特综合征患者为24:85（28%）。这些结果表明，与慢性持续性肝炎相关的非结合胆红素血症的可能原因是肝脏胆红素UDP-葡萄糖醛酸基转移酶活性的后天性降低。数据提示该酶缺陷与慢性持续性肝炎有关。
