Ahlgren A, Hedenborg G, Norman A, Wisén O
Department of Clinical Chemistry, Karolinska Hospital, Stockholm, Sweden.
Scand J Clin Lab Invest. 1988 Jun;48(4):319-26. doi: 10.3109/00365518809167502.
Sera were obtained from 41 alcohol abusers consecutively admitted for detoxication. Blood samples were withdrawn on the second, fourth and seventh days of abstention. Initial bilirubin values were moderately elevated in 10 patients. Determination of the bilirubin subfractions by high performance liquid chromatography showed elevated values of unconjugated (alpha), monoconjugated (beta), diconjugated (gamma) and albumin-bound (delta) bilirubin, in 8, 15, 4 and 15 patients, respectively. During abstention, the total bilirubin value normalized rapidly, only three patients still had values above the upper reference limit after 7 days. In patients with initially elevated values of bilirubin subfractions, only a few had elevated beta and gamma levels on the seventh day, whereas delta levels decreased at a slower rate and remained virtually unchanged. On admission, 27 patients exhibited elevated levels of serum bile acids; these values decreased during abstention and after 7 days only six patients had slightly elevated values. Only five patients had initially elevated levels of alkaline phosphatase (ALP). These became normalized in all but two patients during abstention. The results suggest that mild cholestasis is common among alcohol-abusers without clinically evident liver disease and that these changes are reversible on abstention.
从41名因戒酒而连续入院的酗酒者身上采集血清。在戒酒的第二天、第四天和第七天采集血样。10名患者的初始胆红素值中度升高。通过高效液相色谱法测定胆红素亚组分显示，未结合胆红素（α）、单结合胆红素（β）、双结合胆红素（γ）和白蛋白结合胆红素（δ）升高的患者分别有8例、15例、4例和15例。在戒酒期间，总胆红素值迅速恢复正常，7天后只有3名患者的值仍高于参考上限。在最初胆红素亚组分值升高的患者中，只有少数患者在第七天β和γ水平升高，而δ水平下降较慢且几乎保持不变。入院时，27名患者血清胆汁酸水平升高；这些值在戒酒期间下降，7天后只有6名患者的值略有升高。只有5名患者最初碱性磷酸酶（ALP）水平升高。除两名患者外，其余患者在戒酒期间这些值均恢复正常。结果表明，轻度胆汁淤积在无临床明显肝病的酗酒者中很常见，且这些变化在戒酒时是可逆的。
