良性梗阻性黄疸病人结合胆红素和非结合胆红素的预后价值

目的 :通过对 37例良性梗阻性黄疸病人围减黄手术期血清总胆红素 ( TBil)、结合胆红素 ( Bc)和非结合胆红素 ( Bu)的测定 ,了解其变化规律 ,确定其临床意义。方法 :分别于手术前 1d,手术后 1,3,7,10 ,14 ,18,2 1d采集血标本 ,使用美国干式生化分析仪测定其中 TBil、Bc、Bu的含量。结果 :排泄良好组在减黄术后 TBil、Bc、Bu前几天迅速下降 ,之后平稳消退 ,Bc/TBil不断下降 ,7d后绝大多数病例小于 0 .2 ;排泄不良组中不少病例在术后 TBil、Bc、Bu不但不消退 ,反而有一定的升高 ,原因不明 ,之后缓慢减低 ,在减黄过程中无明显消退阶段 ,Bc/TBil始终大于 0 .2。结论 :Bc/TBil是预测减黄效果的良好指标

Significance of Serum Conjugated and Unconjugated Bilirubin in Patients with Obstructive Jaundice

Objective To evaluate the significance of serum conjugated and unconjugated bilirubin in patients with obstructive jaundice. Methods Blood samples were collected from the patients on the day of biliary drainage and on days 1, 3, 7, 10, 14, 18, and 21 after drainage. The concentrations of total, conjugated and unconjugated bilirubin were measured by EKTACHE 750XRC analyzer. Results The concentrations of total, conjugated and unconjugated bilirubin in the good drainage patients were decreased rapidly in the first several days after drainage, then decreased smoothly. The proportion of serum conjugated bilirubin decreased from 0.519 to 0.045. The hyperbilirubinemia of the poor drainage patients continued after successful biliary drainage, and the concentrations of total, conjugated and unconjugated bilirubin in several patients even increased in the beginning after drainage. The proportion of serum conjugated bilirubin decreased slowly and did not reach the level of 0.2.Conclusion The decreasing in the percentage of conjugated bilirubin indicates an effectiveness of biliary in patients, and the percentage for 7 days has a good prognosis significance.