Clinical significance of serum delta bilirubin during obstructive jandice.

δ-胆红素是一种与白蛋白共价结合的非酶复合物，在血清中以非酶方式形成，具有较长的半衰期，与肝肾功能无关。目的是检查δ胆红素是否反映梗阻性黄疸的持续时间和胆道引流的有效性。在17只狗中形成阻塞性黄疸，持续4天（短期; n=9）或11天（长期; n=8），然后进行胆管外引流。通过高效液相色谱法分析血清总胆红素、直接胆红素和δ-胆红素组分。胆道梗阻前血清中未检测到δ-胆红素。血清总胆红素和直接胆红素迅速升高，并在梗阻后2d内达到平台期，而δ胆红素的浓度和比例逐渐升高，并与梗阻性黄疸的持续时间显著相关。胆道引流前δ-胆红素的比例为28.9（± SY）。[)2.4 42.5（±）SY. [)2.4长期梗阻组占%。短期梗阻组血清总胆红素、直接胆红素和总-δ胆红素下降指数（分别为-0.17、-0.19和-0.26）均显著大于长期梗阻组（分别为-0.10、-0.10和-0.13）（P<0.05）。两组之间δ-胆红素本身的下降指数相似。总之，血清中δ-胆红素的浓度和比例反映了黄疸的持续时间。由于δ-胆红素不排泄到胆汁和尿液中，对器官没有毒性，总胆红素减去δ-胆红素的下降指数，可排泄胆红素分数可能更好地评估胆汁引流的疗效。从21个人体样本中获得了类似的结果。

delta-Bilirubin, a nonenzymatic covalently bound complex with albumin, is nonenzymatically formed in serum and has a long half-life irrespective of hepatorenal function. The aim was to examine if delta-bilirubin reflects the duration of obstructive jaundice and efficacy of biliary drainage. Obstructive jaundice was developed in 17 dogs either for 4 (short term ; n=9) or 11 (long term ; n=8) days and then external biliary drainage was performed. Serum total, direct, and delta-bilirubin fractions were analyzed by high-performance liquid chromatography. delta-Bilirubin was not detectable in serum before biliary obstruction. The serum total and derect bilirubin levels increased rapidly and reached a plateau within 2 days after the biliary obstruction, whereas the concentration and proportion of delta-bilirubin gradually increased and significantly correlated with the duration of obstructive jaundice. Before biliary drainage, the proportion of delta-bilirubin was 28.9(]SY.+-。[)2.4% in the shortterm and 42.5(]SY.+-。[)2.4% in the long-term obstruction group. The decline indices of serum total, direct, and total minus delta-bilirubin in the short-term group (-0.17, -0.19, and -0.26, respectively) were significantly (P<0.05) greater than those in the long-term obstruction group (-0.10, -0.10, and -0.13). The decline index of delta-bilirubin itself was similar between the groups. In conclusion, the concentration and proportion of delta-bilirubin in serum reflect the duration of jaundice. Because delta-bilirubin is not excreted into bile and urine and is not toxic to organs, a decline index of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction might be better to assess the efficacy of biliary drainge. Similar results were obtained from 21 human samples.