Dietmann K, Stork H
Med Klin. 1976 Jun 11;71(24):1047-50.
Nicotinic acid concentrations in the serum over 80 mug/100 ml induce at the start of high dosage nicotinic acid therapy an acute rise in bilirubin to 1-3mg/100 ml serum. Even after postprandial administration there are clearly raised bilirubin concentrations in the serum. After treatment for 1 week with 0.5 g nicotinic acid daily by mouth the bilirubin increase is no longer detectable. The increased bilirubin concentrations in the serum are apparently the result of a transient inhibition of glucuronyl-transferase and is not a symptom of an acute liver disorder. When starting high dosage nicotinic acid therapy, therefore, disorders of the bilirubin metabolism and liver function must be excluded by differential diagnosis in doubtful cases. Further investigations are necessary to see whether the high concentrations of nicotinic acid in the serum cause competition with other drugs for the bilirubin-specific glucuronyl-transferase.
在高剂量烟酸治疗开始时,血清中烟酸浓度超过80微克/100毫升会导致胆红素急性升高至1 - 3毫克/100毫升血清。即使在餐后给药后,血清中胆红素浓度也明显升高。每日口服0.5克烟酸治疗1周后,胆红素升高不再可检测到。血清中胆红素浓度升高显然是葡糖醛酸转移酶短暂抑制的结果,并非急性肝脏疾病的症状。因此,在开始高剂量烟酸治疗时,对于可疑病例必须通过鉴别诊断排除胆红素代谢和肝功能紊乱。有必要进一步研究血清中高浓度的烟酸是否会与其他药物竞争胆红素特异性葡糖醛酸转移酶。