Pieper-Bigelow C, Eckfeldt J, Levitt M D
Research Section, Minneapolis Veterans Affairs Medical Center, MN 55417, USA.
J Lab Clin Med. 1995 May;125(5):654-61.
Recent studies using very sensitive high-performance liquid chromatography (HPLC) techniques have shown that conjugated bilirubin concentrations in normal human serum are about 0.006 mg/dl, much lower than the direct-reacting bilirubin concentrations reported by typical clinical laboratory techniques (up to 0.3 mg/dl). In animal models of cholestasis, we tested the concept that HPLC measurements of true serum conjugated bilirubin would provide a more sensitive indicator of cholestasis than does the conventional measurement. Serum conjugated bilirubin was not detectable (< 0.006 mg/dl) in untreated rats and guinea pigs. After bile duct ligation, the true serum conjugated bilirubin concentration in rats was significantly elevated by 10 minutes, whereas the conventional bilirubin measurement did not become significantly elevated until 120 minutes; comparable values for the guinea pig were 30 and 240 minutes, respectively. Studies of two rat models of drug-induced cholestasis, cyclosporine A and 17 alpha-ethynylestradiol, showed that measurable levels of true conjugated bilirubin appeared in the serum of cyclosporine A-treated rats but not in the estrogen-treated animals. We conclude that true serum conjugated bilirubin concentrations measured by HPLC provide an extremely sensitive means of detecting cholestasis and that such measurements could have clinical utility in detecting very early or minimal liver dysfunction.
最近使用非常灵敏的高效液相色谱（HPLC）技术进行的研究表明，正常人血清中结合胆红素的浓度约为0.006mg/dl，远低于典型临床实验室技术报告的直接反应胆红素浓度（高达0.3mg/dl）。在胆汁淤积的动物模型中，我们测试了这样一个概念，即通过HPLC测量真正的血清结合胆红素比传统测量方法能提供更灵敏的胆汁淤积指标。在未处理的大鼠和豚鼠中，血清结合胆红素无法检测到（<0.006mg/dl）。胆管结扎后，大鼠血清中真正的结合胆红素浓度在10分钟时显著升高，而传统胆红素测量直到120分钟才显著升高；豚鼠的相应值分别为30分钟和240分钟。对两种药物性胆汁淤积大鼠模型（环孢素A和17α-乙炔雌二醇）的研究表明，环孢素A处理的大鼠血清中出现了可测量水平的真正结合胆红素，而雌激素处理的动物血清中未出现。我们得出结论，通过HPLC测量的真正血清结合胆红素浓度提供了一种极其灵敏的检测胆汁淤积的方法，并且这种测量在检测非常早期或轻微的肝功能障碍方面可能具有临床实用性。
