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血清胆汁酸:梗阻性黄疸患者肝功能的替代标志物

Serum bile acid: an alternative liver function marker in the obstructive jaundice patient.

作者信息

Lalisang Toar J M

机构信息

Department of Surgery, Faculty of Medicine, University of Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2012 Jul;44(3):233-8.

Abstract

AIM

to confirm the role of bile acid value as single marker for liver function test as compared to the conventional liver function tests on obstructive jaundice patients.

METHODS

before and after study on severe obstructive jaundice patients was performed from December 2007 until January 2009. The liver function markers were measured before, 7th day and 14th day after bile duct decompression (BDD). Open Cholecystostomy as BDD was used as a model to observe the markers changes. Samples were collected by trained medical professionals and Automated clinical chemistry analyzer (ACA) TRX 7010 was used to measure the markers value. All continuous data were presented as mean (SD) and the variables were compared and analyzed by t-test and multiple measurements test using SPSS v.16 with a p-value of <0.05 considered to be statistically significant.

RESULTS

twenty one patients were included. All patients suffered bile acid accumulation and impairment of all conventional liver functions tests. After decompression, the average serum bile acid decreased significantly (p<0.05). Significant decrease after decompression happened to serum total bilirubin (p<0.05) and serum ALP (p<0.05). A trend towards improvement in coagulation function was evident by the shortening of PT and APTT. The albumin level increased slightly from 2.8 to 2.9 mg/dL while CHE activity was fixed at low level. A decrease in average activity of transaminase enzyme (AST (p<0.05) and ALT) was also observed.

CONCLUSION

the sBA level follow the pattern of changes of classic liver function markers. Serum bile acid could be considered to be used as alternative marker to evaluate liver function, which is simple and applicable.

摘要

目的

与传统肝功能检查相比,确认胆汁酸值作为梗阻性黄疸患者肝功能检查单一标志物的作用。

方法

对2007年12月至2009年1月期间的重度梗阻性黄疸患者进行研究。在胆管减压(BDD)前、第7天和第14天测量肝功能标志物。以开放式胆囊造口术作为BDD模型观察标志物变化。样本由训练有素的医学专业人员采集,使用自动临床化学分析仪(ACA)TRX 7010测量标志物值。所有连续数据均以均值(标准差)表示,使用SPSS v.16通过t检验和多次测量检验对变量进行比较和分析,p值<0.05被认为具有统计学意义。

结果

纳入21例患者。所有患者均存在胆汁酸蓄积以及所有传统肝功能检查指标受损的情况。减压后,血清胆汁酸平均水平显著下降(p<0.05)。减压后血清总胆红素(p<0.05)和血清碱性磷酸酶(p<0.05)显著下降。凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)缩短,提示凝血功能有改善趋势。白蛋白水平从2.8 mg/dL略有升高至2.9 mg/dL,而胆碱酯酶(CHE)活性维持在低水平。转氨酶(AST(p<0.05)和ALT)平均活性也有所下降。

结论

血清胆汁酸水平遵循经典肝功能标志物的变化模式。血清胆汁酸可被视为评估肝功能的替代标志物,其简单且适用。

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