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随着医学科学技术的发展,开展了一些新的试验和检查技术,对黄疸的鉴别诊断具有一定的临床价值,现简要介绍如下: 一、蛋白质代谢试验:1.y、z蛋白测定:(正常值y蛋白4毫微克％,z蛋白40毫微克％)急慢性肝病伴有黄疸时均升高,阻塞性黄疸时改变不显著;2.a、AT(正常值200～300 mg％ ),a_1抗胰蛋白酶为一种糖蛋白,由肝细胞产生,为广谱的蛋白酶抑制剂,肺部疾患尤其是肺癌时明显增高,有人认为HBV阴性的慢性肝炎为a_1AT减少所致,阻塞性黄疸时无变化。二、胆汁酸代谢试验:胆酸(CA)鹅去氧胆酸(CDCA),是胆汁酸代谢的中间产物,它们在肠道细菌作用下产生脱氧胆酸和石胆酸,二者称为次胆酸,少量从肠道排出,大量重吸收,正常血清中CA10～20μg％,CDCA0～2μg％,尿中无次胆酸。急性黄疸性肝炎潜伏期CA、CDCA就可升高,最高可达1500～
With the development of medical science and technology, to carry out a number of new test and inspection techniques, the differential diagnosis of jaundice has some clinical value, are briefly described as follows: First, the protein metabolism test: 1.y, z protein determination: (normal Value y protein 4 ng,% z protein 40 ng) acute and chronic liver disease with jaundice were elevated, obstructive jaundice changed insignificantly; 2.a, AT (normal 200 ~ 300 mg%), a_1 Antitrypsin is a glycoprotein, produced by the liver cells for a broad spectrum of protease inhibitors, lung disease, especially lung cancer was significantly increased, some people think that HBV-negative chronic hepatitis a_1AT reduced due to obstructive jaundice Variety. Second, the bile acid metabolism test: Cholic acid (CA) chenodeoxycholic acid (CDCA), is an intermediate product of bile acid metabolism, they produce deoxycholic acid and lithocholic acid in the intestinal bacteria, both called times Cholic acid, a small amount of excreted from the intestine, a large number of reabsorption, normal serum CA10 ~ 20μg%, CDCA0 ~ 2μg%, no hypochlomate in urine. Acute jaundice hepatitis latency CA, CDCA can be increased, up to 1500 ~