Magnani H N, Alaupovic P
Gastroenterology. 1976 Jul;71(1):87-93.
Quantitative determination of LP-X, abnormal serum low density lipoprotein, was performed on the sera of 620 patients with jaundice in two medical centers, one in Oklahoma City, Oklahoma, and the other in Birmingham, England. The results of serial assays over a period of 5 to 8 days after patient admission to hospital or after onset of jaundice, if this occurred in hospital, correlated best with the type and management of jaundice. In some cases of early cholestatic disease of extrahepatic origin LP-X may be absent, but after the observation period it was found that only 1 of 81 (98%) patients with obstruction of the extrahepatic bile duct system remained negative. Of the remainder, 74 (91%) had or developed levels of LP-X exceeding 300 mg per 100 ml. In addition, 43 (88%) of 49 subjects followed serially showed increases in LP-X concentration, with no change in 3 patients. Of 539 subjects with intrahepatic disease, 14 (26.5%) were LP-X positive and 27 (19.4%) of these had initial LP-X levels higher than 300 mg per 100 ml. During the follow-up period, 35 (74%) of 47 patients with intrahepatic disease showed a reduction of LP-X; of the remaining 12 patients 4 had mitochondrial antibody-positive primary biliary cirrhosis, and 6 had severe cholestasis associated with acute infectious hepatitis and high aspartate transaminase levels. Similar figures for alkaline phosphatase showed less consistent changes during the follow-up period. In this retrospective appraisal the trends and absolute levels of LP-X, in addition to the use of similarly followed levels of the routine liver function tests, allowed better differentiation of jaundice requiring surgical correction from that remediable by medical means exclusively than did the use of the routine liver function tests alone. In addition, LP-X is specific for liver dysfunction, whereas other routine liver function tests are not.
对来自俄克拉荷马城俄克拉荷马州的一家医疗中心以及英国伯明翰的另一家医疗中心的620例黄疸患者血清进行了异常血清低密度脂蛋白LP-X的定量测定。在患者入院后或黄疸发作后（如果黄疸在医院发作）的5至8天内进行的系列检测结果，与黄疸的类型和治疗方法相关性最佳。在一些肝外起源的早期胆汁淤积性疾病病例中，可能不存在LP-X，但经过观察期后发现，81例肝外胆管系统梗阻患者中只有1例（98%）仍为阴性。其余患者中，74例（91%）的LP-X水平达到或超过每100毫升300毫克。此外，49例连续跟踪的受试者中有43例（88%）的LP-X浓度升高，3例无变化。在539例患有肝内疾病的受试者中，14例（26.5%）LP-X呈阳性，其中27例（19.4%）的初始LP-X水平高于每100毫升300毫克。在随访期间，47例肝内疾病患者中有35例（74%）的LP-X水平降低；其余12例患者中，4例患有线粒体抗体阳性的原发性胆汁性肝硬化，6例患有与急性传染性肝炎和高天冬氨酸转氨酶水平相关的严重胆汁淤积。碱性磷酸酶的类似数据显示，在随访期间变化不太一致。在这项回顾性评估中，LP-X的趋势和绝对水平，除了使用同样跟踪的常规肝功能测试水平外，与仅使用常规肝功能测试相比，能更好地区分需要手术矫正的黄疸和仅通过药物手段可治愈的黄疸。此外，LP-X对肝功能障碍具有特异性，而其他常规肝功能测试则不然。
