Siciliano M, Milani A, Marra L, Arringoli D, Rossi L
Istituto di Patologia Medica, Università Cattolica, Sacro Cuore, Roma.
Quad Sclavo Diagn. 1986 Dec;22(4):355-61.
The aim of this paper is to evaluate the relationships among the increase of serum bile acids (SBA) and other common liver function tests in subjects with liver cirrhosis. Our results show that SBA levels are well-correlated with the seriousness of the disease (classified according to Child's criteria), and with the presence of ascites, of oesophageal varices, of hepatic encephalopathy and with the gamma-globulin level. SBA also appear to be well-correlated with total bilirubinemia, and, at a lower extent, with cholesterolemia and albuminemia; no significant linear correlation was found among SBA and cholestasis (alkaline phosphatase, gamma-glutamyl-transpeptidase) or cytolysis (transaminases) indexes. In conclusion, the SBA increase in liver cirrhosis without evidence of cholestasis (as in our patients) seems to be related to liver cell reuptake disturbances and to the presence of porto-systemic shunts, with consequent alterations in entero-hepatic bile salt recirculation.
本文旨在评估肝硬化患者血清胆汁酸(SBA)升高与其他常见肝功能检查之间的关系。我们的结果表明,SBA水平与疾病的严重程度(根据Child标准分类)、腹水、食管静脉曲张、肝性脑病的存在以及γ-球蛋白水平密切相关。SBA似乎也与总胆红素血症密切相关,在较低程度上与胆固醇血症和白蛋白血症相关;在SBA与胆汁淤积(碱性磷酸酶、γ-谷氨酰转肽酶)或细胞溶解(转氨酶)指标之间未发现显著的线性相关性。总之,在无胆汁淤积证据的肝硬化中(如我们的患者)SBA升高似乎与肝细胞再摄取障碍以及门体分流的存在有关,从而导致肠肝胆汁盐循环改变。