Amuro Y, Endo T, Higashino K, Uchida K, Yamamura Y
Gastroenterol Jpn. 1981;16(5):506-13. doi: 10.1007/BF02774522.
The levels and compositions of bile acids in the serum, feces and urine were determined by gas chromatography in male patients with mild and advanced stages of liver cirrhosis, defined by usual clinical and laboratory criteria. Increased concentrations of serum bile acids, a decreased ratio of serum cholic acid plus deoxycholic acid/chenodeoxycholic acid plus lithocholic acid, a reduction of fecal bile acids, especially deoxycholic acid, and a reduction in total daily excretion of bile acids were found in patients with advanced cirrhosis. Furthermore, 3 beta-hydroxy-5-cholenoic acid, a presumed intermediate in the alternate pathway of chenodeoxycholic acid synthesis, was found in the urine of patients with very advanced cirrhosis. Such changes were absent in patients with mild cirrhosis except for increased concentration of serum bile acids and decreased excretion of total bile acids. The present study suggests that marked changes in bile acid metabolism occur only in advanced cirrhosis.
采用气相色谱法测定了依据常规临床和实验室标准界定的轻度和晚期肝硬化男性患者血清、粪便及尿液中胆汁酸的水平和成分。晚期肝硬化患者血清胆汁酸浓度升高，血清胆酸加脱氧胆酸/鹅去氧胆酸加石胆酸的比值降低，粪便胆汁酸减少，尤其是脱氧胆酸，且胆汁酸每日总排泄量减少。此外，在极晚期肝硬化患者的尿液中发现了3β-羟基-5-胆烯酸，这是鹅去氧胆酸合成替代途径中的一种假定中间体。除血清胆汁酸浓度升高和总胆汁酸排泄减少外，轻度肝硬化患者未出现此类变化。本研究表明，胆汁酸代谢的显著变化仅发生在晚期肝硬化患者中。
