血清总胆汁酸酶法测定及其临床应用  

Enzymatic determination for total bile acids in serum and its clinical application

作　　者：杨昌国[1] 许叶[1] 吕邦太[1] 鲍晓霞[2] 斯志萍 夏经波 裘晓梅 周永列[3] 徐朝阳[4] 罗敏[4] 康可上[5] 戎聪伟 徐路耀 

机构地区：[1]宁波市临床检验中心,浙江宁波315000 [2]奉化市人民医院 [3]浙江省人民医院 [4]宁波市第一医院 [5]慈溪市人民医院

出　　处：《临床检验杂志》1997年第6期323-327,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：为了建立酶法测定血清总胆汁酸(TBA)的方法并评价其临床应用价值,对试剂配方和测定条件进行优化实验,并作临床观察。结果,本法灵敏度:50μmol/L A_(500)nm(1 cm)为0.1;线性为0～200μmol/L;精密度:总CV<6.0%;批内CV<3.0%。本法(Y)和日本一化试剂的(X)比较:Y=0.973X+2.72,r=0.9963。用本法测定60名健康人,116例各种肝病患者和211例HBsAg携带者的血清空腹和餐后总胆汁酸(F-TBA和P-TBA)含量。健康组的F-TBA和P-TBA分别为4.9±2.38和8.22±2.91μmol/L。急性肝炎急性期的F-和P-TBA的异常率均为100%,平均增高幅度分别是正常高限的13和11倍。且随疾病的恢复而逐渐转为正常,对肝病的愈后估计优于ALT和AST。慢活肝组的F-TBA异常率亦为100%,均>20μmol/L。而慢迁肝组的F-TBA异常率仅为19%。均<20μmol/L。F-TBA>20μmol/L可作为慢性肝炎活动的指征。肝硬化组的F-和P-TBA均超过正常高限且幅度较大,异常率高于所有常规肝功能试骏。HBsAg携带者的F-TBA异常率为29%,F-TBA正常者中P-TBA的异常率为35%,提示F-和P-TBA测定对检出轻度肝脏损害有较高的灵敏度。Enzymatic mearurement of total bile acids (TBA) was established, and it's clinical significance was evaluated. The compositions of reagent and the programs of analysis were optimization by experiment, and the clinical sigmficance of TBA assay were evaluated by case research. Analytical index of this method: the sensitivity was (A_(500mm)1cm)about 0.1 for 50/μmol/L TBA; the linearity was 0～200μmol/L; the precisions were <6.0% for total CV, and<3.0% for within-run CV. Correlation between results obtained by this method (Y)and kit of Daiichi pure chemicals Co. (X)was Y=0.973X+2.72, r=0.9963. Fasting and postprandial total bile acids (F-TBA and P-TBA)in sera from the 60 healthy adults, 116 patients with various liver diseases and 211 HBsAg carriers were estimated by present method. The x±s of healthy controls were 4.9±2.38 μmol/L for F-TBA and 8.22±2.91μmol/L for P-TBA represently. Frequency of abnormal values that acute hepatitis acute stage were 100% for both F-TBA and P-TBA, and mean rang elevated were 13 and 11 times more than up-limit of normal value for F-TBA and P-TBA represently. The abnormal frequency of F-TBA in active chronic hepatitis group were 100%, and the F-TBA values were>20 μmol/L in all patients with active chronic hepatitis, while all patients with chronic persistent hepatitis were<20μmol/L, so the F-TBA>20μmol/L was useful in differential diagrosis for the active or inactive chronic hepatitis. Both F-TBA and P-TBA values were markedly higher in all patients with cirrhosis, and their abnormal frequency were higher than all conventional liverfunction tests. Abnormal ratio of F-TBA in HBsAg carriers were 29%, and which of P-TBA were 35% in carriers with normal F-TBA value. It is suggested that the sensitivity of F-TBA and P-TBA as liverfunction tests were greatly high. F-TBA and P-TBA assay were excellant liver function indicators.

关 键 词：总胆汁酸 酶法测定 肝疾病 临床应用 

分 类 号：R575.04[医药卫生—消化系统] R446.11[医药卫生—内科学]