腹腔镜和肝活检对Dubin-Johnson综合征诊断的价值  

Diagnosis and differential diagnosis of Dubin Johnson syndrome

作　　者：郭长吉[1] 林三仁[1] 李益农[1] 段晓文[1] 段丽萍[1] 

机构地区：[1]北京医科大学第三医院消化科,北京100083

出　　处：《北京医科大学学报》2000年第2期128-130,共3页Journal of Peking University(Health Sciences)

摘　　要：目的 :探讨 (Dubin Johnsonsyndrome ,DJS)的诊断和鉴别方法。 方法 :对北京医科大学第三医院 196 0～1998年确诊的 10例DJS进行回顾性分析及文献复习。结果 :DJS以慢性持续或间歇性黄疸为主要特征 ,血清胆红素一般轻度升高且以结合胆红素为主 ,ALT及AST正常 ;但并发病毒性肝炎或其它肝病时可升高。口服胆囊造影不显影 ;BSP试验呈典型双峰曲线 ,该方法已被淘汰。腹腔镜下肝脏呈特征性“黑肝”改变 ;肝活检细胞内有棕色或棕黄色色素颗粒沉着。结论 :腹腔镜检查和 /或肝活检是DJS诊断和鉴别诊断的重要方法。Objective: To investigate the optimal methods of the diagnosis and differential diagnosis of DJS. Methods: The clinical manifestations, laboratory tests and other features of 10 cases of DJS which had diagnosed in the Third Hospital of BMU from 1960 to 1998 were analysed and the literatures about DJS were reviewed. Results: DJS was mainly characterized by chronic persistent or intermittent jaundice. The concentration of serum bilirubin, which contained direct bilirubin predominantly, was elevated mildly. The concentrations of its serum ALT and AST were normal except when it was accompanied with viral hepatitis or other hepatopathy. The gallbladder could not be visualized in the oral cholecystography procedure. The serum BSP concentration was usually normal or slightly elevated at 45 min after administration, with a characteristic rise at 90 to 120 min. However, the BSP test is no longer utilized now. At laparoscopy, the colour of its liver was of pathognomonic “black”. Hepatic biopsy showed that there were a lot of brown or brown yellow pigment granules in the hepatocytes. Conclusion: Laparoscopy and/or hepatic biopsy are the very important methods for diagnosis and differential diagnosis of DJS.( J Beijing Med Univ, 2000,32:128 130 )

关 键 词：慢性特发性黄疸 诊断 腹腔镜 肝活检 D-J综合征 

分 类 号：R575.04[医药卫生—消化系统]