Andreuzzi B, Vai C, Santese R, Andreuzzi P, Cantoni L
Minerva Med. 1984 Mar 31;75(13):749-56.
Certain conjugated biliary acids (total pool - choliglycine - sulpholytic choliglycine) and the following haematochemical parameters: total bilirubin and its direct quota, alkaline phosphatase, albumin, prothrombin activity, gamma globulin, oxalacetic and pyruvic transaminase were radioimmunologically (RIA) studied in 115 subjects. Subjects were divided into the following subgroups: --20 normal controls; --20 cases of persistent chronic hepatitis; --20 cases of active chronic hepatitis; --15 cases of A.C.H. with cirrhosis; --20 cases of cirrhosis without direct hyperbilirubinaemia; --20 cases of cirrhosis with direct hyperbilirubinaemia. Each case was assigned to its particular group on the basis of the histological report on each patient. The following observations were drawn from the results obtained: --there is a progressive increase in above normal biliary acid rate in proportion to the gravity of the liver pathology; --choliglycine especially and to a lesser extent the total pool increased sufficiently to distinguish between normal and hepatopathic subjects (PCH and ACH) and also between PCH and ACH patients; --the combination of cirrhosis and ACH causes a significant increase in total pool and chliglycine over levels noted in ACH alone; --in contrast no difference is found between the levels of these acids in inactive (or minimally active) cirrhosis and ACH with cirrhosis; --gamma globulin, oxalacetic and pyruvic transaminase levels were found to have substantially the same diagnostic significance as choliglycine in the early stages of liver diseases. Significant correlations were also encountered between total conjugated biliary acid pool and choliglycine (not in the group with cirrhosis without direct hyperbilirubinaemia) and between total pool and choliglycine with haematochemical cholestasis test results (alkaline phosphatase and total and direct bilirubin) the latter only in the two cirrhotics groups. In conclusion, choliglycine was found to be the most sensitive of the biliary acids routinely measured by RIA and is valuable in clinical practice not as a substitute for the main liver tests but as an extremely useful and sensitive addition to them. In clinical practice, its use is recommended in the diagnosis and monitoring of healthy subjects at risk and those with chronic liver conditions (PCH, ACH, ACH + C).
对115名受试者的某些结合型胆汁酸（总池 - 甘氨胆酸 - 硫酸化甘氨胆酸）以及以下血液生化参数进行了放射免疫分析（RIA）研究：总胆红素及其直接比例、碱性磷酸酶、白蛋白、凝血酶原活性、γ球蛋白、草酰乙酸转氨酶和丙酮酸转氨酶。受试者被分为以下亚组：
20名正常对照组；
20例持续性慢性肝炎患者；
20例活动性慢性肝炎患者；
15例伴有肝硬化的活动性慢性肝炎患者；
20例无直接高胆红素血症的肝硬化患者；
20例有直接高胆红素血症的肝硬化患者。根据每位患者的组织学报告将每个病例归入其特定组。从获得的结果中得出以下观察结果：
上述异常胆汁酸比率随着肝脏病理严重程度的增加而逐渐升高；
特别是甘氨胆酸，总池也有较小程度的增加，足以区分正常人和肝病患者（持续性慢性肝炎和活动性慢性肝炎），也能区分持续性慢性肝炎和活动性慢性肝炎患者；
肝硬化和活动性慢性肝炎的合并导致总池和甘氨胆酸显著高于仅活动性慢性肝炎患者的水平；
相比之下，非活动性（或轻度活动性）肝硬化和伴有肝硬化的活动性慢性肝炎患者的这些酸水平没有差异；
在肝病早期，发现γ球蛋白、草酰乙酸转氨酶和丙酮酸转氨酶水平与甘氨胆酸具有基本相同的诊断意义。在总结合型胆汁酸池与甘氨胆酸之间（无直接高胆红素血症的肝硬化组除外）以及总池与甘氨胆酸和血液生化胆汁淤积试验结果（碱性磷酸酶、总胆红素和直接胆红素）之间也发现了显著相关性，后者仅在两个肝硬化组中存在。总之，发现甘氨胆酸是通过RIA常规测量的胆汁酸中最敏感的，在临床实践中很有价值，不是作为主要肝脏检查的替代，而是作为对它们极其有用和敏感的补充。在临床实践中，建议在诊断和监测有风险的健康受试者以及患有慢性肝病（持续性慢性肝炎、活动性慢性肝炎、活动性慢性肝炎 + 肝硬化）的患者时使用。
