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[The diagnostic value and limitations of total serum bile acid determined enzymatically]
1Liver Disease Center, The Second Hospital of Hunan Medical University, Changsha 410011, China.
Objective:
To elucidate the diagnostic value of total serum bile acid.
Method:
Clinical data from 913 cases was statistically analyzed with SPSS for Windows and other statistical procedures reported previously.
Results:
(1) The mean of TBA of healthy subjects was (4.0 +/- 3.2) micromol/L. The TBA level of liver disease group is significantly higher than other group(P < 0.01). (2) The mean of TBA of patients with acute hepatitis was (167.2 +/- 132.4) micromol/L, the highest value was 449.5 micromol/L, it was significantly higher than other groups. TBA was a sensitive mark reflecting acute hepatic injury. (3) The sensitivity of TBA in patients with cirrhosis was 85.8%, higher than routine liver function tests. TBA is a valuable mark reflecting collateral circulation. (4) The sensitivity of TBA in mild chronic hepatitis was only 30.5%, much lower than ALT and TBIL (P < 0.01). (4) There was a relationship between the level of TBA and the severity of patients' condition, but the value of TBA for evaluating the severity was not as good as TBIL.
Conclusion:
The specificity of TBA is quite high, the sensitivity is moderate, TBA is valuable for the diagnosis of liver disease, especially for acute hepatitis and cirrhosis, but it's sensitivity for mild chronic hepatitis is only 30.5%, it is not as good as TBIL for evaluating the condition of patients.