血清胆汁酸在肝病中的临床应用研究

用改良气相色谱法观察了黑索金，氯乙烯职业接触者及急、慢性肝病、肝癌等血清胆汁酸的变化，发现２种亲肝性毒物致肝损害时胆汁酸变化不同；黑索金组血清石胆酸（ＬＣＡ）、脱氧胆酸（ＤＣＡ）、鹅脱氧胆酸（ＣＤＣＡ）升高，显著性检验有差异；氯乙烯组只有ＬＣＡ、ＤＣＡ升高；变化主要集中在次级胆汁酸。急、慢性肝炎、肝硬化、肝癌等肝损害时血清ＬＣＡ、ＤＣＡ、ＣＤＣＡ和胆酸（ＣＡ）有不同程度升高，以ＣＤＣＡ、ＣＡ变化明显，差异有统计学意义；但比较四种胆汁酸水平的变化无显著性差异，而ＣＡ／ＣＤＣＡ值互有不同，差异有统计学意义。提示血清胆汁酸可用于诊断，鉴别诊断各型肝炎，为临床提供了科学依据。

A STUDY ON THE CLINICAL APPLICATION OF SERUM BILE ACIDS IN LIVER DISEASES.

The changes of serum bile acids(SBA) in workers who exposed to hexogen or chloroethylene and some clinical hepatosis patients,e.g,acute and chronic hepatosis and hepatoma were investigated by a modified gas chromatography.The results revealed:different disturbance of SBA occurred between the liver injuries induced by the two kinds of hepatotoxicant;Lithocholic acid(LCA),deoxycholic acid(DCA) and chenodeoxycholic acid(CDCA) in serum ascended when workers exposed to hexogen,statistic differences were found;on the other hand,only LCA,DCA in serum went up when workers exposed to chloroethlene;But the main changes both concentrated on the secondary bile acids.In 4 kinds of clinical liver disease e.g.Serum LCA,DCA,CDCA and cholic acids(CA) of acute jaundice hepatitis,chronic active hepatitis,liver cirrhosis and hepatoma all went up in different degree,and CDCA,CA changed greater,statistic difference existed,but no statistic difference of 4 kinds of bile acids each other;Only statistic difference of CA/CDCA value appeared.These provided the evidence to the differential diagnosis of clinical hepatobiliary diseases and occupational liver injures.