Jirsová V, Jirsa M, Miková M
Czech Med. 1982;5(3):157-64.
The object of the study was the transformation of bilirubin in the neonatal digestive tract with special reference to enterohepatic circulation of nonconjugated bilirubin and its consequences. The application of biochemical and chromatographic methods showed that bilirubin excreted by neonatal livers was qualitatively distinct from that excreted by adult livers. Already in the first meconium practically all bilirubin conjugated with glucuronic acid was hydrolyzed, which means ample availability of nonconjugated bilirubin for its reresorption by intestines. The enterohepatic circulation of nonconjugated bilirubin could indirectly be demonstrated by early elimination of nonconjugated bilirubin reservoir - meconium - from the digestive tract. This resulted in a significant reduction of bilirubinaemia. It could be shown that in newborns with hyperbilirubinaemia alterations of structure of bilirubin excreted into bile due to phototherapy occurred. This finding leads to an assumption that besides a favourable effect, apparently predominating in bilirubin degradation, phototherapy tends in an undesirable way to increase enteral reabsorption of nonconjugated bilirubin back in the circulation.
本研究的目的是探讨新生儿消化道中胆红素的转化，特别关注未结合胆红素的肠肝循环及其后果。生化和色谱方法的应用表明，新生儿肝脏排泄的胆红素在质量上与成人肝脏排泄的胆红素不同。在最初的胎粪中，几乎所有与葡萄糖醛酸结合的胆红素都被水解，这意味着未结合胆红素可被肠道大量重吸收。未结合胆红素的肠肝循环可通过早期从消化道清除未结合胆红素储存库——胎粪来间接证明。这导致胆红素血症显著降低。结果表明，接受光疗的高胆红素血症新生儿胆汁中排泄的胆红素结构发生了改变。这一发现使人推测，除了在胆红素降解中明显占主导的有利作用外，光疗还可能以不良方式增加未结合胆红素在肠道的重吸收并回到循环中。
