Ludwig-Köhn H, Henning H V, Sziedat A, Matthaei D, Spiteller G, Reiner J, Egger H J
Eur J Clin Invest. 1983 Feb;13(1):91-8. doi: 10.1111/j.1365-2362.1983.tb00070.x.
The neutral steroid fractions in the urine of eleven patients suffering from various forms of liver disease with cholestasis and of ten healthy individuals were studied by glass capillary gas chromatography-mass spectrometry. The steroid conjugates in urine were enzymatically solvolysed, the liberated steroids extracted and transformed into the trimethylsilylether for measurements. The excretion rates of androstane and pregnane metabolites of patients with liver disease were far lower than those of healthy persons. The main compounds in the urine of the former were the bile alcohols 27 - nor - 3 alpha, 7 alpha, 12 alpha, 24 xi, 25 xi - pentahydroxy - 5 beta - cholestane and 3 alpha, 7 alpha, 12 alpha, 25 xi, 26 - pentahydroxy - 5 beta - cholestane. Our data suggest a correlation between the excretion rates of these bile alcohols and the serum levels of bilirubin. While the excretion rate of the two bile alcohols in the urine of healthy individuals was approximately 0.24 mg/24 h (0.6 mumol/24 h) a patient with a serum bilirubin of 841 mumol/l excreted 4 mg/24 h (9 mumol/24 h). The accumulation of bile alcohols described in this study possibly indicates alternative pathways of cholic acid formation in liver disease.
采用玻璃毛细管气相色谱 - 质谱联用技术，对11例患有各种胆汁淤积性肝病的患者及10名健康个体尿液中的中性类固醇组分进行了研究。尿液中的类固醇结合物经酶解、释放出的类固醇经萃取后转化为三甲基硅醚进行测定。肝病患者雄甾烷和孕烷代谢物的排泄率远低于健康人。前者尿液中的主要化合物是胆汁醇27 - 去甲 - 3α，7α，12α，24ξ，25ξ - 五羟基 - 5β - 胆甾烷和3α，7α，12α，25ξ，26 - 五羟基 - 5β - 胆甾烷。我们的数据表明这些胆汁醇的排泄率与血清胆红素水平之间存在相关性。健康个体尿液中这两种胆汁醇的排泄率约为0.24mg/24h（0.6μmol/24h），而血清胆红素为841μmol/L的患者排泄率为4mg/24h（9μmol/24h）。本研究中描述的胆汁醇积累可能表明肝病中胆酸形成的替代途径。
