肝病患者尿中粪卟啉同分异构体测定及其机理探讨

Determination and Investigation of Urinary Coproporphyrin Isomers in Patients with Liver Diseases

应用高压液相色谱法检测三种肝病患者尿中粪卟啉同分异构体含量,并同时检测静脉色氰酸耐量试验.血清胆红素浓度和白蛋白浓度。结果表明:肝硬化组尿中粪卟啉Ⅰ型,游离色氨酸以及白蛋白浓度均与慢活肝组和急性肝炎组有显著差异。提示肝脏的转运功能障碍是尿中粪卟啉同分异构体含量变化的基本因素。对伴有高胆红素血症的肝硬化患者的有关指标作相关分析提示:血清胆红素可能干扰卟啉代谢。

By using high performance liquid chromatography (HPLC), we investigated the mehanism of changes in urinary coproporphyrin isomers in 53 patients with various fiver diseases (including 33 posthepatitic cirrhosis, 14 chronic active hepatitis, and 6 acute hepatitis) with 20 normal subjects as control. Results showed that there was a significant differenoe not only between patients with liver diseases and nonrmal subjects, but also among patients with different fiver diseases. The chaanges in urinary coproporphyrin iscmers in fiver diseases could mainly be attrobutable to disturbances of hepatic transport function. Comparing the urinary coproporphyrin isomers between cirrhotic patients with and without hyperbilirubinemia, there seemed to be some correlation suggesting the presence of some inhibitory effect of bilirubin on porphyrin metabolism.