Duseja Ajay, Das Ashim, Das Reena, Dhiman R K, Chawla Yogesh, Bhansali A
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Trop Gastroenterol. 2005 Jul-Sep;26(3):123-5.
Patients with nonalcoholic steatohepatitis (NASH) have normal liver function tests except for raised transaminases until they have progressed to cirrhosis of liver. The objective of this study was to evaluate patients of NASH for the presence of hyperbilirubinemia at presentation.
Sixty-seven patients of NASH were studied for the presence of hyperbilirubinemia at presentation. All patients were worked up for the presence of cirrhosis and hemolytic work up and fasting test were done in those found with unconjugated hyperbilirubinemia.
Five out of 67 patients (7.5%) of NASH were found to have unconjugated hyperbilirubinemia. Though the fasting test was not positive, they all had a negative hemolytic workup and none of them had underlying cirrhosis. Clinical characteristics of patients with unconjugated hyperbilirubinemia were similar to those with normal serum bilirubin levels.
Unconjugated hyperbilirubinemia in patients with NASH may suggest an associated Gilbert's syndrome.
非酒精性脂肪性肝炎（NASH）患者在发展为肝硬化之前，除转氨酶升高外，肝功能检查均正常。本研究的目的是评估初诊时NASH患者高胆红素血症的情况。
对67例NASH患者初诊时的高胆红素血症情况进行研究。所有患者均进行了肝硬化检查，对发现有非结合胆红素血症的患者进行了溶血检查和空腹试验。
67例NASH患者中有5例（7.5%）发现有非结合胆红素血症。虽然空腹试验结果为阴性，但他们的溶血检查均为阴性，且均无潜在肝硬化。非结合胆红素血症患者的临床特征与血清胆红素水平正常的患者相似。
NASH患者的非结合胆红素血症可能提示伴有吉尔伯特综合征。
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