Endo T, Uchida K, Amuro Y, Higashino K, Yamamura Y
Gastroenterology. 1979 May;76(5 Pt 1):1002-6.
Bile acid compositions in the serum, urine, bile, and feces were examined in a typical case of benign recurrent intrahepatic cholestasis for a period of 3 yr. The serum cholesterol level remained almost constant. The serum and urinary levels of total bile acids increased markedly during the icteric phase but returned to normal toward the anicteric phase. Daily fecal excretion of bile acids in the anicteric phase was about three times the normal value. Bile acids in the bile and feces, and in the serum and urine, mainly consisted of chenodeoxycholic and cholic acids, with little deoxycholic acid even in the anicteric phase. Scarcely any coprostanol was found in the feces. These observations suggest that metabolism by intestinal bacteria was altered in this patient. The ratio of cholic acid/chenodeoxycholic acid in the serum was above 2.0 in the icteric phase but was reduced to 0.9 in the anicteric phase. At least three unusual bile acids, designated as peak 7a, 11, and 13, were detected in the feces. The amount of bile acid in peak 7a reached about 10% of the total in the anicteric phase.
对一例典型的良性复发性肝内胆汁淤积患者的血清、尿液、胆汁和粪便中的胆汁酸成分进行了为期3年的检测。血清胆固醇水平几乎保持恒定。在黄疸期，血清和尿液中的总胆汁酸水平显著升高，但在无黄疸期恢复正常。无黄疸期胆汁酸的每日粪便排泄量约为正常值的三倍。胆汁和粪便以及血清和尿液中的胆汁酸主要由鹅去氧胆酸和胆酸组成，即使在无黄疸期脱氧胆酸含量也很少。粪便中几乎未发现粪甾烷醇。这些观察结果表明该患者肠道细菌的代谢发生了改变。血清中胆酸/鹅去氧胆酸的比值在黄疸期高于2.0，但在无黄疸期降至0.9。在粪便中检测到至少三种异常胆汁酸，分别命名为峰7a、11和13。在无黄疸期，峰7a中的胆汁酸含量约占总量的10%。
