Cherruau B, Nguyen-Dai D, Calmus Y, Dang-Vu B, Marien M, Houssin D
Laboratoire de Biochimie A, Hôpital Cochin, Paris.
Gastroenterol Clin Biol. 1993;17(5):370-5.
Serum delta-bilirubin measured in relationship to total bilirubin could be a liver function test in hepatobiliary diseases and even a marker of early rejection after liver transplantation. Delta-bilirubin bound to albumin constitutes with mono and diglucuroconjugates, conjugated bilirubins. We determined the delta-bilirubin/conjugated bilirubins ratio and studied its value in various complications in 16 liver recipients. The results were compared with alanine aminotransferase activity and prothrombin index. Hyperbilirubinemia and a delta-bilirubin/conjugated bilirubins ratio lower than 40% were observed initially. After 15 days, the delta-bilirubin/conjugated bilirubins ratio evolved differently according to the functional state of the graft, which allowed to distinguish three patient groups: in patients with good graft function, the ratio increased regularly to reach 65% or more on the 30th day; in patients with dysfunctional episodes, the ratio was always less than or equal to 40% and did not increase after the 15th day; in other patients, the ratio was lower than 40% and dropped suddenly before death. After liver transplantation, the delta-bilirubin/conjugated bilirubins ratio may be a simple liver function marker. Alone, however, it cannot be used to assess acute rejection.
与总胆红素相关测量的血清δ胆红素可能是肝胆疾病中的一项肝功能检测指标，甚至是肝移植后早期排斥反应的一个标志物。与白蛋白结合的δ胆红素与单葡萄糖醛酸结合物和双葡萄糖醛酸结合物（即结合胆红素）共同构成。我们测定了16例肝移植受者的δ胆红素/结合胆红素比值，并研究了其在各种并发症中的价值。将结果与丙氨酸转氨酶活性和凝血酶原指数进行比较。最初观察到高胆红素血症以及δ胆红素/结合胆红素比值低于40%。15天后，δ胆红素/结合胆红素比值根据移植物的功能状态呈现不同变化，这使得能够区分出三组患者：移植物功能良好的患者，该比值在第30天有规律地升高至65%或更高；有功能障碍发作的患者，该比值始终小于或等于40%，且在第15天后不再升高；其他患者，该比值低于40%，并在死亡前突然下降。肝移植后，δ胆红素/结合胆红素比值可能是一个简单的肝功能标志物。然而，仅凭它不能用于评估急性排斥反应。
