Ericzon B G, Eusufzai S, Kubota K, Einarsson K, Angelin B
Department of Transplantation Surgery, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Hepatology. 1990 Nov;12(5):1222-8. doi: 10.1002/hep.1840120524.
Biliary lipid metabolism was studied after 10 liver transplantations with continuous drainage of bile. Within 3 wk after transplantation, the new liver produced bile with concentrations of biliary lipids in agreement with those reported for T-tube bile in cholecystectolized nontransplanted subjects. Although changes in biliary lipid composition occurred swiftly in response to various forms of disturbed liver function, they did not provide substantially more information than did standard serum tests or simple measurements of bile flow in most patients. Secretion rates of phospholipids and cholesterol were found to be completely bile acid dependent. For each micromole of bile acids, 0.22 and 0.08 mumol of phospholipids and cholesterol were secreted, respectively. When bile flow was related to bile acid output, a linear relationship was found (r = 0.89), with a positive intercept indicating a bile acid-independent bile flow of approximately 44 microliters/min. Analysis of individual bile acids showed almost exclusively primary bile acids. The relative proportion of chenodeoxycholic acid was more prominent during the first days after transplantation. Different explanations for this are discussed.
对10例接受胆汁持续引流的肝移植患者的胆汁脂质代谢进行了研究。移植后3周内，新肝脏产生的胆汁中胆汁脂质浓度与胆囊切除的非移植受试者中T管胆汁所报道的浓度一致。尽管胆汁脂质组成会迅速响应各种形式的肝功能紊乱而发生变化，但在大多数患者中，它们提供的信息并不比标准血清检测或简单的胆汁流量测量多很多。发现磷脂和胆固醇的分泌率完全依赖于胆汁酸。每微摩尔胆汁酸分别分泌0.22和0.08微摩尔的磷脂和胆固醇。当胆汁流量与胆汁酸输出相关时，发现呈线性关系（r = 0.89），正截距表明胆汁酸非依赖性胆汁流量约为44微升/分钟。对单个胆汁酸的分析显示几乎全是初级胆汁酸。移植后的头几天内，鹅去氧胆酸的相对比例更为突出。对此讨论了不同的解释。
