摘要

BACKGROUND & AIMS:Serum 7alpha-hydroxycholesterol level reflects hepatic bile acid synthesis in humans. The aim of this study was to examine the maximal bile acid synthesis in patients with chronic liver diseases.
METHODS:Cholestyramine (12 g/day) was administered for 3 days to patients with compensated liver cirrhosis (n = 7), patients with chronic hepatitis (n = 10), and control subjects (n = 9), and serum total 7alpha-hydroxycholesterol level was measured by gas-liquid chromatography-mass spectrometry.
RESULTS:A preliminary study showed that cholestyramine increased the serum value to the maximum by the third day. Before cholestyramine treatment, there were no significant differences in serum 7alpha-hydroxycholesterol levels among the groups. Three days of cholestyramine treatment increased the serum levels 5.71 +/- 2.90-fold in the controls, 3.25 +/- 0.85-fold in patients with chronic hepatitis, and 1.70 +/- 0.78-fold in cirrhotic patients. Cirrhotic patients had significantly lower serum 7alpha-hydroxycholesterol levels after the treatment compared with other groups. Serum 7alpha-hydroxycholesterol levels stimulated by cholestyramine significantly correlated with serum albumin levels and indocyanine green retention rate.
CONCLUSIONS:Three days of cholestyramine loading increased the bile acid synthesis to its maximal level. The cholestyramine test showed that patients with chronic hepatitis had enough hepatic reserve for bile acid synthesis; however, patients with compensated liver cirrhosis had significantly decreased capacity.

译文

背景与目的: 血清 7 α-羟基胆固醇水平反映人体肝胆汁酸合成。本研究的目的是检测慢性肝病患者的最大胆汁酸合成。
方法: 对代偿期肝硬化患者 (n = 7) 、慢性肝炎患者 (n = 10) 给予胆甾胺 (12g/天) 3 天, 和对照组 (n = 9)，用气相-液相色谱-质谱联用法测定血清总 7 α-羟基胆固醇水平。
结果: 初步研究表明，消胆胺在第 3 天将血清值提高到最大值。在利胆胺治疗前，各组间血清 7 α-羟基胆固醇水平无显著差异。三天的消胆胺治疗使对照组的血清水平提高了 5.71/-2.90 倍，慢性肝炎患者的血清水平提高了 3.25/-0.85 倍, 肝硬化患者的 1.70/-0.78 倍。与其他组相比，肝硬化患者治疗后血清 7 α-羟基胆固醇水平显著降低。胆碱胺刺激的血清 7 α-羟基胆固醇水平与血清白蛋白水平和吲哚青绿保留率显著相关。
结论: 三天的胆酸负荷使胆汁酸合成达到最大水平。利胆胺试验表明，慢性肝炎患者有足够的肝脏储备来合成胆汁酸; 然而，代偿性肝硬化患者的能力明显下降。