肝硬化患者中血清总胆汁酸测定的临床意义

背景：胆汁酸在肝内合成和分泌，因此可以作为反映肝细胞损害的指标之一。目的：探讨肝硬化患者血清总胆汁酸（TBA）测定的临床意义。方法：收集42例肝硬化患者的肝功能资料，比较TBA与其他常规肝功能指标的敏感性差异。结果：肝硬化组的TBA显著高于健康对照组（P＜0．01），其水平为健康对照组的6．9倍，异常率为74％，显著高于丙氨酸转氨酶（ALT）、γ－谷氨酰转移酶（γ－GT）和碱性磷酸酶（ALP）（P＜0．01）。肝硬化失代偿期患者的TBA水平显著高于代偿期患者（P＜0．01）。结论：TBA是反映肝硬化患者肝细胞损害的敏感指标之一。     

检测肝硬化患者血清前白蛋白和总胆汁酸水平的临床意义

目的　探讨肝硬化患者血清前白蛋白 (PA)与总胆汁酸 (TBA)水平关系及其变化的临床意义。方法　用日本产CL 72 0 0全自动生化分析仪分别检测 10 2例肝硬化患者及 3 0例正常献血员血清PA、TBA水平。结果　肝硬化患者血清PA明显低于正常对照组 (P <0 .0 1) ,TBA明显高于正常对照组 (P <0 .0 1) ,且随肝功能损伤程度的加重PA值逐渐下降 ,TBA值逐渐升高 ;肝硬化患者血清PA与TBA水平呈明显负相关 (r =-0 .682 ,P <0 .0 1)。结论　肝硬化患者存在血清PA水平下降 ,TBA水平升高 ,血清PA与TBA呈明显负相关 ,联合检测血清PA、TBA水平能较早地反映肝脏合成及其代谢功能 ,对病情和预后的早期判断有重要的临床价值     

乙型肝炎患者血脂、血清前白蛋白和总胆汁酸变化的意义

目的探讨乙型肝炎患者血脂、血清前白蛋白和总胆汁酸的变化规律,了解其与病情及预后的关系。方法在230例乙型肝炎患者[其中急性肝炎43例,慢性肝炎91例(轻度25例,中度32例,重度34例),重型肝炎33例,肝炎肝硬化63例]和50例正常人,测定血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、血清前白蛋白(PA)、白蛋白(ALB)、总胆汁酸(TBA)水平。结果各组总胆汁酸水平较正常对照组升高,差别有显著性意义(P<0·05);慢性肝炎组、肝硬化组、重型肝炎组患者血清甘油三脂、总胆固醇、HDL-C、血清前白蛋白、白蛋白水平均较正常对照组降低,差别有显著性意义(P<0.05);各项血脂水平随着肝功能损害的加重而降低(慢性肝炎重度组和中度组显著低于轻度组,重型肝炎组显著低于慢性肝炎组和肝硬化组)。结论检测乙型肝炎患者血脂、血清前白蛋白和总胆汁酸水平,对了解肝功能状态和估计预后均有一定的意义。     

慢性肝病患者血清总胆汁酸测定的临床意义

目的探讨各种慢性肝病患者血清总胆汁酸测定的临床意义。方法测定慢性肝病（脂肪肝、肝硬化及原发性肝癌）患者血清总胆汁酸浓度及其它肝功能指标[丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）],并与对照组进行比较。结果（1）慢性肝病患者血清TBA水平较对照组均升高,肝硬化及原发性肝癌患者血清TBA水平与对照组比较有显著性差异（P〈0.05）,且肝硬化患者升高更加显著（P〈0.01）;（2）肝硬化患者TBA随着child-pugh分级A、B、C级的升高逐渐递增,且C级与A、B级之间TBA水平比较有显著性差异（P〈0.01）;（3）脂肪肝、肝硬化及原发性肝癌患者的TBA阳性率分别为28.6%、88.3%和100%,肝硬化患者的TBA阳性率高于ALT、AST和TBIL;（4）肝硬化患者Child-Pugh C级TBA阳性率与A、B级比较差异有显著性（P〈0.05）,Child-Pugh分级B、C级TBA阳性率显著高于其他肝功能实验指标（P〈0.05）。结论血清TBA水平是反映肝实质损害的一项灵敏指标,对监测肝病的病情发展、严重程度、预后及治疗效果等方面具有重要的参考价值,而且在分析肝硬化患者肝损害方面比常规肝功能项目更为灵敏。     

血清总胆汁酸和4项肝纤维化指标与肝硬化Child-Pugh分级的关系

背景：血清总胆汁酸（TBA）以及肝纤维化指标Ⅲ型前胶原（PCU1）、Ⅳ型胶原（C-Ⅳ）、层黏蛋白（LN）和透明质酸（HA）水平可判断肝硬化程度，但国内外研究关于肝纤维化指标与Child-Pugh分级关系的结果并不完全一致。目的：研究肝硬化患者血清TBA含量以及PCⅢ、C-Ⅳ、LN、HA水平与肝硬化Child-Pugh分级的关系。方法：按Child．Pugh分级标准将42例肝硬化患者分为A、B、C三级，酶法测定血清TBA含量，放射免疫测定法检测空腹血清PCⅢ、C．IV、LN、HA水平。结果：血清TBA含量随Child．Pugh分级增高而升高，不同分级间有显著差异（P〈0．01）。肝功能C级患者血清PCU1水平显著高于A级患者（P〈0．05），各级肝功能患者间血清C-Ⅳ水平均无显著差异，肝功能C级患者血清LN水平显著高于A级和B级患者（P〈0．01，P〈0．05），肝功能B级和C级患者血清HA水平均显著高于A级患者（P〈0．01）。结论：血清TBA含量能灵敏地反映肝硬化患者肝功能损害程度，对指导肝硬化患者肝功能分级具有很好的参考价值；联合检测肝硬化患者血清PCU1、LN、HA对指导肝功能的分级也有一定意义。     

老年肝硬化患者血清白蛋白、前白蛋白、胆碱酯酶、胆汁酸检测的意义

目的探讨血清白蛋白(ALB)、前白蛋白(PAB)、胆碱酯酶(ChE)和胆汁酸(BA)的检测对老年肝硬化患者肝功能评价与预后评估的价值。方法对93例老年肝硬化患者治疗前后血清ALB、PAB、ChE、BA等水平对比分析,以36例老年肝损害患者为对照组。结果肝硬化组ALB、PAB、ChE水平明显下降(P0.01),BA水平明显增高,但差异无显著性(P0.05)。结果联合检测血清ALB、PAB、ChE和BA有助于老年肝硬化患者肝功能评估与预后判断。     

不同肝病患者血清前白蛋白和白蛋白的检测及意义

测定165例不同肝病患者和38例健康者血清前白蛋白、白蛋白、总蛋白水平,以及23例慢性肝炎、20例肝硬化患者治疗前后血清前白蛋白水平的变化.发现各肝病组血清前白蛋白均明显低于正常对照组;HBsAg携带者组血清白蛋白无明显改变,其他肝病组与正常对照组比较差异显著.肝硬化、肝癌患者血清总蛋白明显低于对照组;慢性肝炎组与肝硬化组治疗前后血清前白蛋白水平差异显著;慢性肝炎组、肝硬化组、肝癌组血清前白蛋白与白蛋白水平变化呈正相关关系.提示血清前白蛋白能灵敏地反映肝功能损害并有助于判断肝病的病情及预后.     

血清总胆汁酸测定在肝硬化临床诊断中的价值

血清总胆汁酸(TBA)分析正逐渐成为肝病患者肝功能受损和病情进展的有用指标[1].为了探讨血清TBA测定在老年肝硬化临床诊断中的应用价值,本研究回顾性分析了2010年3月至2012年3月112例老年肝硬化患者的临床资料及血清TBA检测结果,并与青年肝硬化患者进行对比研究. 1资料与方法 1.1 一般资料选择2010年3月至2012年3月在我院接受诊治的老年肝炎肝硬化患者112例,其中男82例,女30例;年龄60 ～ 79[平均(69.10 ±9.03)]岁;选择同期在我院接受诊治的青年肝炎肝硬化患者100例,其中男74例,女26例;年龄30～51[平均(39.85 ±9.11)]岁.112例老年肝炎肝硬化患者按照Child-Pugh分级,其中A级39例,B级42例,C级31例.     

肝硬化患者血清C3、C4、CRP与TBA水平的相关性

目的探讨肝硬化患者血清补体3（C3）、补体4（C4）、C反应蛋白（CRP）与总胆汁酸（TBA）水平相关性及其水平变化的临床意义。方法采用国赛NS II型特定蛋白分析仪,免疫散射比浊法和日本产CL-7200全自动生化分析仪分别检测102例肝硬化患者及30例正常献血员对照的血清C3、C4、CRP及TBA水平。结果肝硬化患者血清C3与TBA水平呈明显负相关（r=-0.492,P〈0.01）,而CRP与TBA水平呈明显正相关（r=0.598,P〈0.01）;肝硬化患者血清C3明显低于对照组（P〈0.01）,CRP、TBA明显高于对照组（P〈0.01）,且随肝硬化功能分级C3值逐渐下降,CRP、TBA值逐渐升高,Child-Plugh,C级组同时伴有C4水平下降,与对照组相比（P〈0.01）。结论肝硬化患者存在血清C3水平下降,CRP、TBA水平升高,联合检测血清C3、C4、CRP、TBA水平能较早地反映肝脏合成及其代谢功能,对病情和预后的早期判断有重要的临床价值。     

肝硬化患者血清胆固醇、胆碱酯酶、总胆汁酸的变化及临床意义探讨

目的探讨肝硬化患者血清总胆固醇(Tch)、胆碱酯酶(ChE)、总胆汁酸(TBA)变化的临床意义。方法检测92例肝硬化患者及68例健康者的Tch、ChE及TBA水平。结果肝硬化组Tch、ChE水平低于对照组(P<0.05),TBA水平显著高于对照组(P<0.01),Tch、ChE在肝功能Child-Pugh分级C级中最低,TBA在C级中最高,与A级和B级相比存在显著性差异(P<0.01)。结论血清Tch、ChE、TBA能较准确地提示肝细胞的损害程度,判断肝硬化病情,估计预后。     

MEASUREMENT OF 3'-MONOIODOTHYRONINE IN HUMAN SERUM

An heterologous radioimmunoassay for measurement of 3'-monoiodothyronine (3'T1) has been developed using pure 3'T1 as standard, (¹²⁵I) DL3'T1 and an anti 3,3'L-diiodothyronine antiserum. The assay utilizes Sephadex G25F minicolumns to separate 3'T1 from other endogenous iodothyronines. 8-ani-lino-1-naphthalene sulphonic acid was used to inhibit binding of 3'T1 to serum binding proteins. Sensitivity was approximately 3·2 pmol/l. The mean serum 3'T1 concentration was 7·4 pmol/l in normal subjects, 30·8 pmol/l in thyrotoxic patients, 4·1 pmol/l in hypothyroid patients, 23·2 pmol/l in patients with severe non-thyroidal illness and 109·8 pmol/l in cord blood. Increased levels of 3'T1 were found in two normal volunteers who were injected with 3,3'T2, demonstrating that 3'T1 is derived from 3,3'T2 in extrathyroidal tissues. These studies suggest that 3'T1 is a minor iodothyronine metabolite in the human. It is unlikely to have significant biological relevance.     

A STUDY OF SERUM BIOCHEMISTRY IN BEHcET'S SYNDROME

Serum samples from 57 Turkish patients with Behçet'ssyndrome (BS) were analysed for C-reactive protein, histidine.total sulphydryl concentration and gamma glutamyl transpeptidase.Clinical subgroups did not exhibit biochemical differences,including BS with and without arthritis. When compared withnormal controls and with patients with active rheumatoid arthritis(RA), those with BS were shown to be biochemically abnormalin a manner quantitatively similar to RA, but to a lesser degree.Gamma-glutamyl transpeptidase concentrations were found to benormal in BS. KEY WORDS: Behçet's syndrome, Biochemistry     

SIZE HETEROGENEITY OF IMMUNOREACTIVE PROLACTIN IN HYPERPROLACTINAEMIC SERUM

Thirty-five samples of serum with levels of immunoreactive prolactin greater than 500 mu/l have been fractionated by gel filtration. In samples from seven normal subjects with elevated prolactin levels following TRH or insulin stimulation and samples from twelve patients with prolactin levels greater than 1500 mu/l, over 80% of the immunoreactive material eluted in the position of native or ‘little’ prolactin. In eleven out of sixteen samples containing 500 to 1500 mu/l the proportion of ‘little’ prolactin was less than 80% and more than 20% eluted as ‘big-big’ prolactin. It appears therefore that patients with moderately elevated levels of immunoreactive prolactin may not have genuine hyperprolactinaemia.     

SERUM TRIIODOTHYRONINE CONCENTRATION IN THE DIAGNOSIS OF HYPERTHYROIDISM

The serum triiodothyronine concentration is superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in the diagnosis of hyperthyroidism. Over a 14 month period fifty-five patients attending an endocrine clinic with suspected thyrotoxicosis of all degrees of severity had blood taken on initial attendance and the serum was stored for routine thyroid function tests and triiodothyronine estimation. The patients were followed up and forty-six proved to be toxic and seven to be euthyroid; two could not be classified. Analysis of the initial serum showed that the serum triiodothyronine concentration was superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in predicting the clinical outcome.     

肺螨症患者血清免疫球蛋白测定

本文采用免疫单扩散法测定了51份肺螨症患者血清的免疫球蛋白IgG、IgA和IgM含量,并以生物素-亲和素酶联免疫吸附试验(ABC-ELISA)测定了其中16份血清的IgE含量。结果显示患者IgM水平与对照组相近,而IgG(169.77±46.91/ml)、IgA(308.39±91.83U/ml)和IgE(458.90±273.64U/ml)则明显增高。提示螨类吸入肺部后可刺激机体引起体液免疫反应。     

THE RADIOIMMUNOASSAY OF THYROXINE IN UNEXTRACTED HUMAN SERUM

A specific, accurate, precise and simple radioimmunoassay for thyroxine (T₄) in small volumes of unextracted serum is described. It discriminates well between levels found in different states of thyroid function. Levels in euthyroid subjects range between 4.3 and 11.2 μg/100 ml (mean 7.7); in untreated hyperthyroid subjects, 13.2-25.6 μg/100 ml (mean 19.2); and in untreated hypothyroid subjects undetectable to 2.6 μg/100 ml (mean 1.4). There is satisfactory correlation with competitive protein binding and protein bound iodine methods. Because of its advantages over previous techniques, it is suggested that T₄ radioimmunoassay will become the routine method of assessing thyroid status.
The measurement of serum thyroxine (T₄) is the single most important test in the routine laboratory assessment of thyroid status. Ideally the T₄ assay should be specific, cheap, simple and have a high sample capacity. Thyroxine is determined most commonly in serum extracts by competitive protein binding (CPB) methods (Murphy & Pattee, 1964; Ekins et al ., 1969) or, indirectly, by estimation of serum protein bound iodine (PBI). Both techniques require the processing of relatively large volumes of serum before assay. The PBI method has the added disadvantage of measuring iodine-containing compounds other than thyroxine (Acland, 1971).
We report here a specific, precise and simple radioimmunoassay for thyroxine in unextracted human serum and its application to the assessment of thyroid status. It has significant advantages over CPB, PBI and previous radioimmunoassay methods.