Lindblad L, Lundholm K, Schersten T
Scand J Gastroenterol. 1977;12(4):395-400. doi: 10.3109/00365527709181679.
Total bile acid concentration was determined in systemic and portal serum and in liver tissue from patients with presumably normal liver function, and from patients with extrahepatic cholestasis. Systemic and portal serum bile acids were also determined in patients with alcoholic liver cirrhosis. In 5 patients, in whom a portal catheter was inserted through the umbilical vein, the diurnal variation in systemic and portal serum bile acid concentration was studied. In patients with presumably normal liver function the fasting systemic serum bile acid concentration was 4.8+/-0.5 mumol times 1(-1), and the portal concentration was 12.9+/-1.5 mumol times 1(-1). In cholestasis and liver cirrhosis the systemic and portal bile acid concentration was substantially elevated. The bile acid concentration gradient between systemic serum, portal serum, liver tissue, and hepatic bile was 1:3:80:2600 in the patients with normal liver function. In both the cholestatic and cirrhotic condition the systemic and portal serum bile acid concentration was equilibrated. Postprandially both the systemic and portal bile acid concentration increased, but the gradient between these concentrations was unchanged. The results are compatible with the hypothesis that portal and systemic serum bile acid concentrations are determined by the intestinal absorption rate in subjects with normal liver function and by the hepatic and renal clearance capacity in cholestatic and cirrhotic conditions.
测定了肝功能可能正常的患者以及肝外胆汁淤积患者的全身和门静脉血清及肝组织中的总胆汁酸浓度。还测定了酒精性肝硬化患者的全身和门静脉血清胆汁酸。对5例通过脐静脉插入门静脉导管的患者，研究了全身和门静脉血清胆汁酸浓度的昼夜变化。肝功能可能正常的患者空腹时全身血清胆汁酸浓度为4.8±0.5μmol·L⁻¹，门静脉浓度为12.9±1.5μmol·L⁻¹。在胆汁淤积和肝硬化患者中，全身和门静脉胆汁酸浓度显著升高。肝功能正常的患者全身血清、门静脉血清、肝组织和肝胆汁之间的胆汁酸浓度梯度为1:3:80:2600。在胆汁淤积和肝硬化状态下，全身和门静脉血清胆汁酸浓度达到平衡。餐后全身和门静脉胆汁酸浓度均升高，但这些浓度之间的梯度不变。这些结果与以下假设相符：在肝功能正常的受试者中，门静脉和全身血清胆汁酸浓度由肠道吸收率决定；在胆汁淤积和肝硬化状态下，由肝脏和肾脏的清除能力决定。
