Foberg U, Broström C, Frydén A, Glaumann H, Kågedal B, Mårtensson J, Tobiasson P, Weiland O
Liver. 1987 Apr;7(2):116-22. doi: 10.1111/j.1600-0676.1987.tb00327.x.
In 40 patients with histologically verified chronic hepatitis, (chronic persistent hepatitis, n = 13; chronic active hepatitis without, n = 14; or with cirrhosis, n = 13), of viral and autoimmune origin, serum bile acids (SBA) were measured before and during 3 h after oral ingestion of 1 g chenodeoxycholic acid (CDA). Fasting SBA were elevated in 22 (55%) patients, whereas the CDA loading test was abnormal in 15 (38%) patients and the galactose elimination was prolonged in 16 (40%) patients. In patients with chronic active hepatitis, 20/27 had elevated SBA either in the fasting state (18/27) or after the CDA loading test (13/27). Normal SBA values were found in 9/13 (70%) patients with chronic persistent hepatitis. Thus, fasting SBA is not sensitive enough to detect mild chronic inflammatory liver disease as chronic persistent hepatitis, but seems to be as sensitive as the galactose elimination or CDA loading tests in detecting potential severe liver disease. Fasting SBA may thus be used as a complement of conventional liver tests in the follow-up of chronic hepatitis as assessment of liver function. An oral CDA loading and an i.v. galactose elimination test add no further information to that given by fasting serum bile acids.
在40例经组织学证实的慢性肝炎患者中（慢性持续性肝炎13例、无肝硬化的慢性活动性肝炎14例、有肝硬化的慢性活动性肝炎13例），病因包括病毒感染和自身免疫，在口服1g鹅去氧胆酸（CDA）之前及之后3小时内测定血清胆汁酸（SBA）。22例（55%）患者空腹SBA升高，而15例（38%）患者CDA负荷试验异常，16例（40%）患者半乳糖清除延长。在慢性活动性肝炎患者中，27例中有20例在空腹状态（27例中的18例）或CDA负荷试验后（27例中的13例）SBA升高。9/13（70%）慢性持续性肝炎患者SBA值正常。因此，空腹SBA对于检测如慢性持续性肝炎这样的轻度慢性炎症性肝病不够敏感，但在检测潜在的严重肝病方面似乎与半乳糖清除试验或CDA负荷试验一样敏感。因此，空腹SBA可作为慢性肝炎随访中评估肝功能的传统肝功能检查的补充。口服CDA负荷试验和静脉注射半乳糖清除试验并未提供比空腹血清胆汁酸更多的信息。
