Matsui A, Psacharopoulos H T, Mowat A P, Portmann B, Murphy G M
J Clin Pathol. 1982 Sep;35(9):1011-7. doi: 10.1136/jcp.35.9.1011.
Serum glycocholic acid (SGC) was measured by radioimmunoassay in 277 samples from 122 children with hepatobiliary disorders and from 23 healthy age-matched controls. In patients with hepatobiliary disease the SGC was more frequently abnormal (83%) than values for serum albumin (7%), prothrombin time (17%), bilirubin (22%), alkaline phosphatase (45%), aspartate transaminase (57%) and gammaglutamyl transpeptidase (63%). The cumulative frequency of abnormality of these six tests was equal to that of SGC alone. Serum glycocholic acid concentrations were raised in 13 patients in whom all other tests of liver function were normal. Two of these had clinical and histological evidence of liver disease, while four had biopsy-proven hepatic fibrosis or cirrhosis, and two of three with chronic active hepatitis in remission subsequently relapsed. Four patients have as yet, no other clinical or biochemical evidence of continuing liver disease. Serum glycocholic acid was normal in seven children with abnormal aspartate transaminase or gammaglutamyl transpeptidase in whom there is strong suspicion of significant hepatic disease. A wide range of values of SGC was found with marked overlap between the values found in the different disease entities studied. The SGC value was related to the serum concentration of aspartate transaminase and gammaglutamyl transpeptidase but not to other tests of liver function. Serum glycocholic acid concentration was considered in relation to the severity of histological abnormality in 25 percutaneous liver biopsies. The extent of the rise in SGC was related to the presence or degree of histological severity of oedema in the portal tracts, disruption of the limiting plate, parenchymal fibrosis and hepatocellular necrosis but not to other histological features. The very high incidence of abnormal SGC values found in this study does suggest that in an ordinary inpatient and outpatient service SGC determination is a practical and sensitive indicator of the presence of significant liver disease but for its comprehensive identification aspartate transaminase and gammaglutamyl transpeptidase must also be determined.
采用放射免疫分析法对122例患有肝胆疾病的儿童和23例年龄匹配的健康对照者的277份样本进行血清甘氨胆酸（SGC）检测。在患有肝胆疾病的患者中，SGC异常的频率（83%）高于血清白蛋白（7%）、凝血酶原时间（17%）、胆红素（22%）、碱性磷酸酶（45%）、天冬氨酸转氨酶（57%）和γ-谷氨酰转肽酶（63%）。这六项检测异常的累积频率与单独SGC异常的累积频率相当。在13例其他肝功能检测均正常的患者中，血清甘氨胆酸浓度升高。其中2例有肝脏疾病的临床和组织学证据，4例经活检证实有肝纤维化或肝硬化，3例缓解期慢性活动性肝炎患者中有2例随后复发。4例患者目前尚无其他持续肝病的临床或生化证据。7例天冬氨酸转氨酶或γ-谷氨酰转肽酶异常且高度怀疑有严重肝病的儿童，其血清甘氨胆酸正常。研究发现SGC值范围广泛，不同疾病实体的检测值之间有明显重叠。SGC值与天冬氨酸转氨酶和γ-谷氨酰转肽酶的血清浓度相关，但与其他肝功能检测无关。对25例经皮肝活检组织学异常的严重程度进行了SGC血清浓度分析。SGC升高的程度与门管区水肿、界板破坏、实质纤维化和肝细胞坏死的组织学严重程度或存在程度有关，但与其他组织学特征无关。本研究中发现SGC值异常的发生率非常高，这确实表明在普通住院和门诊服务中，SGC测定是存在严重肝病的实用且敏感指标，但要全面识别还必须同时测定天冬氨酸转氨酶和γ-谷氨酰转肽酶。
