Williams C N
Clin Biochem. 1976 Jun;9(3):149-52. doi: 10.1016/s0009-9120(76)80038-0.
Primary bile acids are exclusively synthesize, and all bile acids are conjugated, in the liver. When hepatic function is altered by disease, not surprisingly the bile-acid metabolism reflects this change. 1. In chronic liver disorders the glycine: taurine ratio of serum and bile is reduced. 2. In cases of relapsing acute hepatitis and relapsing chronic active hepatitis the serum bile acids are increased, providing an aid to early diagnosis. Their pattern often distinguishes chronic cholestatic conditions from Laennec's cirrhosis. 3. In chronic liver disease, the concentration of intraduodenal bile acids is reduced; when the reduction is severe, this probably accounts for co-existent steatorrhoea. 4. In Laennec's cirrhosis, both the synthesis and pool size of cholic acid are markedly depressed; in primary biliary cirrhosis, however, preliminary data indicate a decrease in the chenodeoxycholic acid component.
初级胆汁酸仅在肝脏中合成，并且所有胆汁酸都会在肝脏中进行结合。当肝功能因疾病而改变时，胆汁酸代谢反映出这种变化也就不足为奇了。1. 在慢性肝脏疾病中，血清和胆汁中的甘氨酸：牛磺酸比例降低。2. 在复发性急性肝炎和复发性慢性活动性肝炎病例中，血清胆汁酸升高，有助于早期诊断。其模式常常能将慢性胆汁淤积性疾病与Laennec肝硬化区分开来。3. 在慢性肝病中，十二指肠内胆汁酸浓度降低；当降低严重时，这可能是同时存在脂肪泻的原因。4. 在Laennec肝硬化中，胆酸的合成和池大小均显著降低；然而，在原发性胆汁性肝硬化中，初步数据表明鹅去氧胆酸成分减少。
