Enzymatic determination for total bile acids in serum and its clinical application

Enzymatic mearurement of total bile acids (TBA) was established, and it's clinical significance was evaluated. The compositions of reagent and the programs of analysis were optimization by experiment, and the clinical sigmficance of TBA assay were evaluated by case research. Analytical index of this method: the sensitivity was (A_(500mm)1cm)about 0.1 for 50/μmol/L TBA; the linearity was 0～200μmol/L; the precisions were 6.0% for total CV, and3.0% for within-run CV. Correlation between results obtained by this method (Y)and kit of Daiichi pure chemicals Co. (X)was Y=0.973X+2.72, r=0.9963. Fasting and postprandial total bile acids (F-TBA and P-TBA)in sera from the 60 healthy adults, 116 patients with various liver diseases and 211 HBsAg carriers were estimated by present method. The x±s of healthy controls were 4.9±2.38 μmol/L for F-TBA and 8.22±2.91μmol/L for P-TBA represently. Frequency of abnormal values that acute hepatitis acute stage were 100% for both F-TBA and P-TBA, and mean rang elevated were 13 and 11 times more than up-limit of normal value for F-TBA and P-TBA represently. The abnormal frequency of F-TBA in active chronic hepatitis group were 100%, and the F-TBA values were20 μmol/L in all patients with active chronic hepatitis, while all patients with chronic persistent hepatitis were20μmol/L, so the F-TBA20μmol/L was useful in differential diagrosis for the active or inactive chronic hepatitis. Both F-TBA and P-TBA values were markedly higher in all patients with cirrhosis, and their abnormal frequency were higher than all conventional liverfunction tests. Abnormal ratio of F-TBA in HBsAg carriers were 29%, and which of P-TBA were 35% in carriers with normal F-TBA value. It is suggested that the sensitivity of F-TBA and P-TBA as liverfunction tests were greatly high. F-TBA and P-TBA assay were excellant liver function indicators.