利福平试验对Gilbert综合征诊断价值的评价  

The evaluation of rifampin test in the diagnosis of patients with Gilbert′s syndrome

作　　者：刘浩[1] 鲁晓擘[1] 肖琳[1] 孙晓凤[1] 张跃新[1] 吕荣福[1] 

机构地区：[1]新疆医科大学第一附属医院感染科,830054

出　　处：《肝脏》2008年第3期208-210,共3页Chinese Hepatology

摘　　要：目的评价利福平试验对Gilbert综合征的诊断价值。方法收集已确诊的Gilbert综合征患者42例,分为Gilbert综合征组29例、Gilbert综合征合并慢性乙型肝炎病毒(HBV)感染组13例(均为长期反复或持续轻度间接高胆红素血症,但转氨酶始终正常),全部采用利福平试验。先在清晨空腹采血测定血清胆红素,然后口服利福平600mg,4h后再测血清胆红素。判定标准:口服利福平后,血清间接胆红素水平大于基线值2倍者定为强阳性;大于基线值50%为弱阳性;小于基线值50%或间接胆红素<17.10μmol/L(1mg/dl)者为阴性。结果利福平试验前后血清间接胆红素水平有明显差异(P<0.01),利福平试验诊断Gilbert综合征的阳性率为88.1%。对Gilbert综合征合并慢性HBV感染患者(HBV病毒携带者、非活动性HBsAg携带者),利福平试验未发现有明显的影响。结论利福平试验可用于诊断Gilbert综合征,对Gilbert综合征合并慢性HBV感染也有诊断价值。Objective To study the effect of the rifampin test in patients with Gilbert＇s syndrome. Methods We conducted a clinical trail of 42 patients diagnosed to have with Gilbert＇s syndrome. To divide into Gilbert＇s syndrome 29 patients and 13 patients with Gilbert＇s syndrome and CHB （HBV carrier, nonactively HBsAg carrier）. Each participant taken a rifampin test,ie, first to take empty stomach blood examination measured bilirubin in the morning, then measured bilirubin at 4h after the administration of 600mg of rifampin. More than two fold increase above the baseline of indirect bilirubin level was accepted as a complete response for the rifampin test. An increase in indirect bilirubin level of〉50% of baseline after the tests was defined as a partial response,and an increase in indirect bilirubin level of〈50% of baseline,or an indirect bilirubin level below 1 mg/dl at the end of tests,was accepted as a negative response. Results Rifampin test caused a significant increase in indirect bilirubin level in patients with Gilbert＇s syndrome（P〈0. 01）. The positive of rifampin test were 88. 1%. We did not find it clearly that the rifampin test had influence on patients with Gilbert＇ s syndrome accompany with HBV carrier and Gilbert＇s syndrome. Conclusion Rifampin test was a valuable method to diagnose Gilbert＇s syndrome, further,it was also valuable for Gilbertr s syndrome with CHB （HBV carrier,nonactive HBsAg carrier.

关 键 词：GILBERT综合征 诊断 利福平试验 

分 类 号：R575[医药卫生—消化系统] R735.7[医药卫生—内科学]