肾移植受者血清总胆汁酸水平变化的影响因素分析

目的　探讨肾移植受者血清总胆汁酸（ＴＢＡ） 水平变化的影响因素及发病机制。方法　用酶比色法测定２０５ 例肾移植受者的ＴＢＡ 浓度。结果　本组２０５ 例肾移植受者中，ＴＢＡ 升高４７ 例， 异常率为２３ ％ 。同时伴有肝酶异常、血清总胆红素升高、肝炎病毒学标志物阳性、合并感染、肝脏Ｂ 超异常、排斥反应、低白蛋白血症、血环孢素Ａ（ＣＳＡ） 谷浓度过高和高胆固醇血症为ＴＢＡ 升高的重要影响因素。结论　ＴＢＡ 是肾移植受者肝脏病损的一个敏感指标， 同时也可提示感染、排斥反应、ＣＳＡ 中毒和体内蛋白质、脂质代谢紊乱的存在。

Analysis on Influential Factors of Change of Serum Total Bile Acid Level in Renal Transplant Recipients

Objective To inquire into the influential factors and pathogenesis of change of serum total biliary acid(TBA) level in renal transplant recipients.Method The levels of TBA in serum from 205 cases with renal graft were measured with enzymetic colorimetry.Results Forty seven of 205 renal graft cases had the elevated TBA.The abnormal rate in this group was 23%(47/205).The significant influential factors of TBA elevation included abnormal hepatic function,elevation of serum total billirubin,positive markers of hepatitis virology, complicated infections,abnormal B mode ultrasound manifestion of liver,rejection,hypoalbuminemia,elevation of valley point concentration of blood cyclosporin A(CSA) and hypercholesterolemia.Conclusions TBA is a sensitive parameter for hepatic damage in renal transplant recipients,and also indicates the presence of infection,rejection,CSA poisoning and metabolic disorder of protein and lipid.