Rothuizen J, van den Ingh T
Department of Small Animal Medicine, University of Utrecht, The Netherlands.
Am J Vet Res. 1988 May;49(5):702-4.
We investigated the occurrence of covalently protein-bound bilirubins in the plasma of dogs with hyperbilirubinemia attributable to hepatobiliary diseases or Coombs test-positive hemolysis. The bilirubins in plasma were measured with the conventional Van den Bergh reaction, by treatment with diazotized p-iodoaniline, and by high-performance liquid chromatography of bilirubin and its methylesters after alkaline methanolysis. All but one dog had covalently protein-bound bilirubin conjugates. The concentration and the fraction of total bilirubins varied in all diseases investigated, but they tended to be low in primary hemolysis. The "biliprotein" complex accounted for 2 to 94% of total plasma bilirubins. Because biliprotein usually is not cleared by the liver, but has a half-life comparable with that of albumin, it prevents the evaluation of the actual state of the underlying disease. Measurement of the total bilirubin concentration exclusively with the Van den Bergh reaction, therefore, is clinically useless. Other methods should be introduced for routine bilirubin assays, permitting the measurement of noncovalently bound pigment as a meaningful estimate of the course of the disease.
我们研究了患有因肝胆疾病或库姆斯试验阳性溶血导致高胆红素血症的犬血浆中与蛋白质共价结合的胆红素的发生情况。采用传统的范登堡反应、用重氮化对碘苯胺处理以及在碱性甲醇解后对胆红素及其甲酯进行高效液相色谱法来测定血浆中的胆红素。除一只犬外，所有犬均有与蛋白质共价结合的胆红素共轭物。在所有所研究的疾病中，总胆红素的浓度和比例各不相同，但在原发性溶血中往往较低。“胆蛋白”复合物占血浆总胆红素的2%至94%。由于胆蛋白通常不能被肝脏清除，但其半衰期与白蛋白相当，因此它会妨碍对潜在疾病实际状态的评估。因此，仅用范登堡反应测量总胆红素浓度在临床上毫无用处。应引入其他方法进行常规胆红素检测，以便能够测量非共价结合的色素，作为对疾病进程的有意义评估。
