Nakamura K, Yoneda M, Kimura A, Tamori K, Yokohama S, Sato Y, Kato T, Hasegawa T, Saito H, Aoshima M, Fujita M, Makino I
Second Department of Medicine, Asahikawa Medical College, Japan.
J Gastroenterol Hepatol. 1996 Apr;11(4):385-90. doi: 10.1111/j.1440-1746.1996.tb01388.x.
The present study was undertaken in order to investigate the influence of ursodeoxycholic acid (UDCA) on the composition of sulfate-conjugated bile acids in the serum and urine of patients with chronic active hepatitis and compensated liver cirrhosis. After a 12 week UDCA treatment (600 mg/day), total serum bile acid concentration increased two-fold in patients with compensated liver cirrhosis and increased slightly in patients with chronic active hepatitis. The percentage of sulfated bile acids significantly increased in patients with both compensated liver cirrhosis and chronic active hepatitis. UDCA made up 63% of the total serum bile acids in compensated liver cirrhosis and 61% in chronic active hepatitis after UDCA treatment. Of the serum bile acids after UDCA treatment, 35.2 and 53.9% of UDCA was sulfate conjugated in compensated liver cirrhosis and chronic active hepatitis, respectively. Urinary excretion of total bile acid and UDCA after UDCA treatment in compensated liver cirrhosis were higher than in chronic active hepatitis. UDCA made up 68% of the total urinary bile acids in compensated liver cirrhosis and 64% in chronic active hepatitis after UDCA treatment. Of the urinary bile acids after UDCA treatment, 51.8 and 54.8% of UDCA was sulfate conjugated in compensated liver cirrhosis and chronic active hepatitis, respectively. UDCA treatment for compensated liver cirrhosis was less effective than for chronic active hepatitis. We found that sulfate conjugation is one of the major metabolic pathways for UDCA after UDCA treatment in chronic liver diseases.
本研究旨在探讨熊去氧胆酸（UDCA）对慢性活动性肝炎和代偿期肝硬化患者血清及尿液中硫酸结合型胆汁酸组成的影响。经过12周的UDCA治疗（600毫克/天），代偿期肝硬化患者的血清总胆汁酸浓度增加了两倍，慢性活动性肝炎患者的血清总胆汁酸浓度略有增加。代偿期肝硬化和慢性活动性肝炎患者的硫酸化胆汁酸百分比均显著增加。UDCA治疗后，代偿期肝硬化患者血清总胆汁酸中UDCA占63%，慢性活动性肝炎患者中占61%。UDCA治疗后的血清胆汁酸中，代偿期肝硬化和慢性活动性肝炎患者分别有35.2%和53.9%的UDCA与硫酸结合。代偿期肝硬化患者经UDCA治疗后总胆汁酸和UDCA的尿排泄量高于慢性活动性肝炎患者。UDCA治疗后，代偿期肝硬化患者尿总胆汁酸中UDCA占68%，慢性活动性肝炎患者中占64%。UDCA治疗代偿期肝硬化的效果不如治疗慢性活动性肝炎。我们发现，在慢性肝病中，硫酸结合是UDCA治疗后UDCA的主要代谢途径之一。
