Stein T A, Burns G P, Wise L
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York 11042.
J Surg Res. 1989 Mar;46(3):226-9. doi: 10.1016/0022-4804(89)90061-9.
Serological tests may be of value in differentiating acute and chronic bile duct obstruction because the rate of alteration of hepatic cellular integrity and function will affect the rate of cellular product release. In a canine model the common bile duct was obstructed either suddenly (N = 7) or gradually (N = 5). A control group (N = 5) had the common bile duct dissected free from the surrounding tissues. Blood was taken before and 1, 2, 4, 7, 11, 14, 17, 21, and 28 days after initiating obstruction. Serum alkaline phosphatase, bilirubin, aspartate aminotransferase, alanine aminotransferase, ornithine carbamyl transferase, and gamma-glutamyl transferase levels were significantly greater with sudden compared to gradual occlusion, and the values were larger than those in the control. The range of values of alkaline phosphatase, bilirubin, and aspartate aminotransferase did not overlap in the acute and chronic groups at specific times. Serum albumin and total protein were normal in all groups. The magnitude of alkaline phosphatase, aspartate aminotransferase, and bilirubin elevation may help in the differentiation of acute and chronic biliary obstruction.
血清学检测对于鉴别急性和慢性胆管梗阻可能具有价值，因为肝细胞完整性和功能的改变速率会影响细胞产物的释放速率。在一个犬类模型中，胆总管被突然（N = 7）或逐渐（N = 5）阻塞。一个对照组（N = 5）将胆总管从周围组织中游离出来。在开始阻塞前以及阻塞后1、2、4、7、11、14、17、21和28天采集血液。与逐渐阻塞相比，突然阻塞时血清碱性磷酸酶、胆红素、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、鸟氨酸氨甲酰转移酶和γ-谷氨酰转移酶水平显著更高，且这些值大于对照组。在特定时间，急性和慢性组中碱性磷酸酶、胆红素和天冬氨酸氨基转移酶的值范围没有重叠。所有组的血清白蛋白和总蛋白均正常。碱性磷酸酶、天冬氨酸氨基转移酶和胆红素升高的幅度可能有助于鉴别急性和慢性胆道梗阻。
