SERUM, CEREBROSPINAL-FLUID, AND BRAIN LEVELS OF BILE-ACIDS IN PATIENTS WITH FULMINANT HEPATIC-FAILURE
SERUM, CEREBROSPINAL-FLUID, AND BRAIN LEVELS OF BILE-ACIDS IN PATIENTS WITH FULMINANT HEPATIC-FAILURE
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DOI：
10.1136/gut.18.9.692
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发表时间：
1977-01-01
期刊：
影响因子：
24.5
通讯作者：
WILLIAMS, R
中科院分区：
文献类型：
--
作者：
BRON, B;WALDRAM, R;WILLIAMS, R
对10例暴发性肝衰竭(FHF)患者死亡后即刻血清、脑脊液和脑组织中胆汁酸水平进行了测定。FHF患者血清胆汁酸主要以结合态为主，所有10例患者的总胆汁酸水平均高于正常对照组(85.9.+-)。Se 8.4，比5.7。+-。0.4nmol/ml，P<；0.001。FHF患者的脑脊液(1.2.5.3nmol总胆汁酸/毫升)和脑活检组织(1.0-18.8nmol/g湿重)均可检出少量但有意义的胆汁酸，而无肝病证据的死亡患者脑脊液和脑活检组织中均未检出。在5例FHF患者尸检中，血清、脑脊液或脑水平与昏迷持续时间或存在脑水肿无关。FHF患者的血清胆汁酸水平与无脑病的慢性肝病患者相似，但低于体外发现的抑制脑呼吸的患者。这些化合物在FHF昏迷发病机制中的主要作用似乎不太可能。
Bile acid levels were measured in the sera, CSF and brain tissue of 10 patients immediately after death from fulminant hepatic failure (FHF). Serum bile acids in FHF were predominantly conjugated, and total bile acid levels were higher in all 10 patients than in normal controls (85.9 .+-. SE 8.4 compared with 5.7 .+-. 0.4 nmol/ml, P < 0.001). Small but significant amounts could be detected in CSF (range 1.2.5.3 nmol total bile acid/ml) and brain biopsies (1.0-18.8 nmol/g wet weight) of FHF patients; none could be detected in CSF and brain biopsies of patients dying without evidence of liver disease. There was no relationship between serum, CSF, or brain levels and duration of coma, or presence of cerebral edema found in 5 FHF patients at necropsy. Serum bile acid levels were similar in FHF to those found in chronic liver disease without encephalopathy and lower than those found to inhibit brain respiration in vitro. A primary role for these compounds in the pathogenesis of coma in FHF seems unlikely.