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題名 | Measurements of Serum Bilirubin Fractions in Obstructive Jaundice=血清分層膽色素在阻塞性黃膽治療前後的變化 |
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作者姓名(中文) | 李昭宏; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 25:4 民81.07-08 |
頁次 | 頁1266-1273 |
分類號 | 415.456 |
關鍵詞 | 血清分層膽色素; 阻塞性黃膽; |
語文 | 英文(English) |
中文摘要 | 本研究利用17位阻塞性黃膽患者,在治療前後,觀察其血清中總膽色素、接合型膽色素、非接合型膽色素及δ膽色素的變化,以了解其臨床意義。 在正常血清中,非接合型臆色素約佔總膽色素的81.8%,而δ膽色素佔18.2%,接合型膽色素則測不到。然而,在阻塞性黃膽患者,其黃膽主要是由接合型膽色素升高所致,通常佔總膽色素的50%以上。當黃膽緩解時,早期主要是因"接合型"膽色素從膽汁排出,其中佔總膽色素的比例由治療前的49.6%降至治療後的3.3%,而"非接合型"及"δ"膽色素在早期黃膽緩解時變化不大。臨床的進展主要是與接合型ˇ膽色素下降的程度成正比。另外在黃膽的病程中,δ膽色素的測定值常隨阻塞時間長短而有異,而關於黃膽緩解後期,δ膽色素卻取代接合型膽色素成為總膽色素的主要成份。另外,δ膽色素與總膽色素的比例似乎在預測黃膽的疾病並無太大的幫助。在研究的觀察中,尿中膽色素主要是與"接合型"膽色素的存在有關,而與"δ"及"非接合型"膽色素無關。 本研究顯示在阻塞性黃膽中,接合型膽色素在膽色素群中是最重要的一種分層膽色素,它可以直接反應肝臟疾病的嚴重程度。雖然δ膽色素在評估肝臟疾病並沒有很大幫助,但它的存在卻使我們對於長期黃膽患者有更深的瞭解。因此,同時連續測定血清中總膽色索及接合型膽色素,足以監測阻塞性黃膽的療程。 |
英文摘要 | We investigated the changes of serum conjugate (Bc), unconjugate (Bu), delta (Bd) and total (TBIL) bilirubins of seventeen patients in the course of obstructive jaundice by Ektachem slide method. In normal sera ,total bilirubin is composed mainly ofthe unconjugated form (81.8%) and a lesser delta bilirubin (18.2%), whereas conjugate bilirubin is almost undetectable. In jaundiced patients, conjugate bilirubin rose proportionally as jaundice progress, and usually occupied over half of total bilirubin. After obtaining effective drainage, the decrease of total bilirubin is mainly due to the excretion of conjugate bilirubin via bile from pre-treatment 49.6% to post-treatment 3.3% of total bilirubin in the early stage of resolution, and the clinical improvement seems directly in proportion with the degree of Bc declined but not of Bu and Bd. Delta bilirubin is variable in the course of jaundice which seems dependent on the duration rather than the cauae of jaundice. In the later stage of resolution, Bd constituted the predominant form about 59.3% oftotal bilirubin, Bu is 37.4% of that with a trace amount of Bc. Furthermore, delta bilirubin and its ratios has been observed to be less significant in predicting the outcome of liver disease. Significantly observed, urinary bilirubin is related to the existence of.Bc and not to that of Bd or Bu. Among the bilirubin profile, conjugate bilirubin is the most important fraction rather than delta and unconjugate bilirubins in reflecting the severity of the disease. Although delta bilirubin is less useful in evaluation of liver diseases, but its existence may help us understand the status of patients in prolongedjaundice. Therefore, the simultaneous measurements of conjugate and total bi1irubins are enough to monitor the course of obstructive jaundice. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。