Poley J R, Caplan D B, Magnani H N, Alaupovic P, Smith E I, Campbell D P, Bhatia M, Burdelski M, Bojanovski D
Eur J Clin Invest. 1978 Dec;8(6):397-404. doi: 10.1111/j.1365-2362.1978.tb00871.x.
Lipoprotein-X (LP-X) was determined before and after the administration of cholestyramine in fifty-five infants with persistent cholestatic jaundice to differentiate between intra- and extrahepatic disease. In twenty-seven infants with biliary atresia, serum LP-X prior to cholestyramine ranged from 0.87 to 11.42 g/l (mean: 3.43 g/l; the average concentration was significantly lower (P less than 0.001) in males. After cholestyramine, LP-X rose in twenty-three, remained the same in two, and decreased slightly in two infants. Serum LP-X was present in twenty of the twenty-eight infants with intrahepatic cholestasis prior to cholestyramine in concentrations from 0.84 to 14.19 g/l (mean: 3.13 g/l). After cholestyramine, LP-X decreased in all by an average of 78% (P less than 0.005). The other eight infants did not have LP-X before or after cholestyramine. This study shows that LP-X in the serum of infants with cholestatic jaundice indicates severe cholestasis, but is not itself diagnostic of biliary atresia. The differentiation of biliary atresia from other diseases is readily achieved, as the administration of cholestyramine for 2-3 weeks causes a marked decrease of serum LP-X in patients with patent extrahepatic bile ducts. The absence of serum LP-X excludes biliary atresia.
对55例持续性胆汁淤积性黄疸婴儿在服用消胆胺前后测定脂蛋白-X（LP-X），以鉴别肝内和肝外疾病。在27例胆道闭锁婴儿中，服用消胆胺前血清LP-X范围为0.87至11.42g/l（平均：3.43g/l；男性平均浓度显著较低（P小于0.001））。服用消胆胺后，23例LP-X升高，2例保持不变，2例略有下降。28例肝内胆汁淤积婴儿中，20例在服用消胆胺前血清LP-X浓度为0.84至14.19g/l（平均：3.13g/l）。服用消胆胺后，所有婴儿的LP-X平均下降78%（P小于0.005）。另外8例婴儿在服用消胆胺前后均未检测到LP-X。本研究表明，胆汁淤积性黄疸婴儿血清中的LP-X表明存在严重胆汁淤积，但本身不能诊断胆道闭锁。由于对肝外胆管通畅的患者服用消胆胺2至3周会导致血清LP-X显著下降，因此很容易将胆道闭锁与其他疾病区分开来。血清LP-X缺失可排除胆道闭锁。
