Sensing H
Z Gesamte Inn Med. 1982 May 1;37(9):267-71.
In 24 persons with healthy liver and 44 patients with without exception morphologically ascertained chronic hepatopathies of different degree of severity the diagnostic valency of the bile acids was tested. In these cases the bile acids estimated in the C-bile proved as sensitive indicators of a chronic lesion of the liver parenchyma. Quantitative deviations of the bile acids, the relation from tri- to dihydroxycholan acids, qualitative alterations in the spectre of the free bile acids as well as changes of the form of conjugation were of importance concerning the functional diagnosis. The concentration of bile acids decreased the more expressed was the chronic lesion of the liver parenchyma. Trihydroxycholan acids and dihydroxycholan acids variably participated in the reduction of the bile acids in different forms of chronic hepatopathies. From the change of the quotient tri- to dihydroxycholan acids causal connections between the degree of severity of the chronic hepatopathy and the dominance of the chenodesoxycholic acid could be derived. Moreover, the conjugation of the bile acids with glycine prevailing in chronic hepatopathies underwent a degradated change. From the examinations results that quantitative and qualitative deviations of the bile acid spectre under defined morphological prerequisites render possible a differentiated judgment of the liver function in chronic hepatopathies.
在24名肝脏健康者以及44名经形态学确诊患有不同严重程度慢性肝病的患者中，对胆汁酸的诊断价值进行了检测。在这些病例中，经C胆汁检测的胆汁酸被证明是肝实质慢性病变的敏感指标。胆汁酸的定量偏差、三羟基胆酸与二羟基胆酸的比例、游离胆汁酸谱的定性改变以及结合形式的变化对于功能诊断具有重要意义。肝实质慢性病变越明显，胆汁酸浓度下降越明显。在不同形式的慢性肝病中，三羟基胆酸和二羟基胆酸以不同方式参与胆汁酸的减少。从三羟基胆酸与二羟基胆酸的比值变化中，可以得出慢性肝病严重程度与鹅去氧胆酸优势之间的因果关系。此外，慢性肝病中以甘氨酸为主的胆汁酸结合发生了降解变化。从检查结果来看，在特定形态学前提下胆汁酸谱的定量和定性偏差使得对慢性肝病肝功能进行鉴别判断成为可能。
