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尿液结合性胆红素的纯化

华西医科大学学报 2001年第4期32卷 579-581页

作者：郭元彪陈曼玲涂屹罗红权李胜利严大刚牛敏华西医科大学基础医学院生物化学教研室 610041 攀枝花市中心医院四川省妇幼保健院

目的　探索一种来源方便 ,具有延续性 ,利于胆红素测定校准物或质控物制备 ,且方法简便、实用、产率和纯度可靠的结合性胆红素 (Bc)纯化方法。方法　应用 CHCl3 ∶ CH3 CH2 OH(1∶ 1,V/V)萃取与 CNBractivated Sepharose4B- HSA亲和层... 详细信息

目的　探索一种来源方便 ,具有延续性 ,利于胆红素测定校准物或质控物制备 ,且方法简便、实用、产率和纯度可靠的结合性胆红素 (Bc)纯化方法。方法　应用 CHCl3 ∶ CH3 CH2 OH(1∶ 1,V/V)萃取与 CNBractivated Sepharose4B- HSA亲和层析相结合的方法对胆道梗阻性高胆红素尿液进行分离纯化 ,并以 Doum as J- G法和 HPL C分析产品。结果　由 CHCl3 ∶ CH3 CH2 OH(1∶ 1,V/V)萃取所得的粗纯品经 J- G法检测产率为 90 .2±5 .4% (n=3) ,胆红素含量占总干重的 6 7.9± 6 .4% (n=3)。亲和层析的洗脱峰间的分离度为 1.5、1.737。层析后再萃取所得精纯品经 HPL C分析 ,产率为 46 .9% ,纯度 94.7% ,其中 BDG76 .2 % ,BMG18.5 %。结论　采用有机物萃取和 CNBr activated Sepharose4B- HSA亲和层析相结合的方法纯化结合性胆红素 (BMG& BDG)

关键词：结合性胆红素亲和层析尿液纯化方法

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肝胆管结石的术后中医治疗

中国医药指南 2008年第23期6卷 339-340页

作者：王永升莱阳市中医医院肝胆科 261053

肝胆管结石是临床常见结石病之一,也是临床常见急腹症之一。临床治疗大多以手术为主,但术后复发率较高。据临床资料表明,肝胆管结石手术后复发结石再手术者高达20%～30%。

关键词：肝胆管结石急腹症再手术结合性胆红素结石病胆汁酸盐胆固醇结石手术后复发胆石症胆色素结石

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急、慢性肝炎胆汁淤积

实用内科杂志 1985年第7期 344-345页

作者：邬祥惠上海第一医学院华山医院

引起肝内胆汁淤积的病因很多,常见原因有急性和慢性病毒性肝炎。急性淤胆型肝炎的发病率约占病毒性肝炎总数的1～2%。其发病机理过去认为是胆小管阻塞的结果。近年来通过电镜和组织化学等研究,认为本病发生机理主要由于胆汁分泌、排泄功能

关键词：毛细胆管肝内微丝胆小管胆汁淤积胆道疾病泥沙样结石慢性淤胆型肝炎结合性胆红素一分钟胆红素急性淤胆型肝炎黄疽

双亲遗传性黄疸:同时发生突变导致吉尔伯特和杜宾—约翰逊综合征

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 29-30页

作者： Cebecauerova D. Jirasek T. Budisova L. M. Jirsa 王志宇 Laboratory of Experimental Hepatology Institute for Clinical and Experimental Medicine Videnska 1958/9 140 21 Praha 4- Krc Czech Republic Dr.

Background & Aims: Dubin- Johnson syndrome is recessively inherited, conjugated hyperbilirubinemia induced by mutations in the ABCC2/MRP2 gene encoding the canali- cular transporter for conjugated bilirubin. Gilbert’ s syndrome is recessively inherited, unconjugated hyperbilirubinemia caused by decreased conjugation rate of bilirubin associated mostly with homozygous A(TA)7TAA variant of the TATAA- box in the UGT1A1 gene promoter. Our aim was to establish the molecular diagnosis in a 3- year- old male with atypical, intermittent, predominantly unconjugated, hyperbilirubinemia. Methods: 99mTc- HIDA cholescintigraphy was used for imaging the biliary tree. Expression of ABCC2/MRP2 protein in hepatocytes was investigated immunohistochemically. UGT1A1 and ABCC2/ MRP2 genes were sequenced from genomic DNA, and the mutations were verified by fragment analysis, sequencing the cloned exons, and restriction fragment length polymorphism. Results: Cholescintigraphy revealed delayed visualization of the gallbladder. A brown granular lipopigment differing from melanin- like pigment reported in Dubin- Johnson syndrome was present in hepatocytes, but, otherwise, liver histology was normal. ABCC2/MRP2 protein was not detected on the canalicular membrane of hepatocytes, and 2 novel mutations were found in the ABCC2/MRP2 gene: a heterozygous in- frame insertion deletion mutation 1256insCT/delAAACAGTGAACCTGATG in exon 10 inherited from the father and a heterozygous deletion 4292delCA in exon 30 inherited from the mother. In addition, the patient was homozygous for - 3279T > G and A(TA)7TAA mutations in the UGT1A1 gene promoter. Conclusions: Our patient represents a case of digenicmixed hyperbilirubinemia - a distinct type of constitutive jaundice resulting from coinherited defects in ABCC2/MRP2 and UGT1A1 genes.

关键词：结合性胆红素吉尔伯特分子诊断肝脏组织学肝细胞基因突变免疫组化法纯合性 DNA 隐性遗传

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肝包虫并发胆总管包虫致梗阻性黄疸一例

西北国防医学杂志 1993年第4期14卷 63-63页

作者：邓永志曹建书李辉荣第23医院外一科 830006

患者,男,20岁.主诉上腹部钝痛1月、加重3天入院.病人生长在新疆.入院时查体:T36.5℃,P74/min,BP16/10kPa,巩膜轻度黄染,心肺未见异常.右上腹轻度深压痛,无反跳痛,莫菲氏征阳性,未触及包块.血常规:Hb137g/L,WBC6.2×10~9/L,N0.72,L0.28.... 详细信息

患者,男,20岁.主诉上腹部钝痛1月、加重3天入院.病人生长在新疆.入院时查体:T36.5℃,P74/min,BP16/10kPa,巩膜轻度黄染,心肺未见异常.右上腹轻度深压痛,无反跳痛,莫菲氏征阳性,未触及包块.血常规:Hb137g/L,WBC6.2×10~9/L,N0.72,L0.28.肝功:总胆红素30mmol/L,结合性胆红素20.6mmol/L,尿胆红素(++),B超示肝右叶见7.7cm×9.2cm花瓣样的无回声区,胆囊13cm×3.3cm,壁毛糙,胆总管直径1.6cm,胸片未见异常,Casoni试验(卌),入院诊断:①肝包虫病;②急性胆囊炎;③胆总管下段梗阻,原因待查.术中见肝表面无明显异常,胆囊肿大,充血,壁薄,切除胆囊。

关键词：肝包虫病胆总管下段急性胆囊炎结合性胆红素莫菲氏征肝右叶巩膜轻度黄染阻性总胆红素上腹部

肝脏透析的体内量化:白蛋白透析和分次血浆分离的比较

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 54-54页

作者： Krisper P. Haditsch B. Stauber R. 王志宇 Division of Nephrology and Hemodialysis Department of Internal Medicine Medical University Graz Auenbruggerplatz 27 A-8036 Graz Austria

Background/Aims: Artificial liver support represents a potentially useful option for the treatment of severe liver failure. A sufficient ‘ dose’ might be crucial for such treatments to provide a survival benefit. The aim of this study was to compare in vivo efficiency and resulting delivered treatment dose of two commercially available devices that use different therapeutic principles: albumin dialysis (AD, MARS ) and fractionated plasma separation (FPS, Prometheus ). Methods: Eight patients with acute-on-chronic liver failure were treated alternately with AD and FPS. Thirty-two treatments at identical blood and dialysate flow rates were evaluated. Clearance and reduction ratio (a measure of delivered treatment dose)were compared for bilirubin subfractions, ammonia and urea. Results: FPS achieved significantly higher clearance for all measured protein-bound and water-soluble markers. This resulted in significantly higher reduction ratios for FPS compared to AD. Unconjugated bilirubin, a marker for strongly albumin-bound toxins, was influenced only by FPS. Conclusions: FPS provided a higher delivered treatment dose than a matching treatment with AD. Reduction ratios of bilirubin and urea should be reported in clinical studies on liver dialysis, since delivered dose is likely to be linked to the clinical effectiveness of extracorporeal liver support therapies.

关键词：血浆分离肝衰竭患者慢性肝衰竭结合性胆红素治疗原理人工肝支持尿素清除率结合蛋白临床效应

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母乳性黄疸的原因

开卷有益（求医问药） 1999年第6期 40-40页

发黄1个多月了。医生认为是母乳性黄疸,请问吃母乳为什么会引起黄疸? 吉林吴×× [答]本病的原因还未弄清楚,据推测与血中的一种酶(葡萄糖醛酸转移酶)

关键词：母乳性黄疸葡萄糖醛酸结合性胆红素未结合胆红素转移酶据推测白眼球热量摄入皮肤医生