胆汁酸代谢及其异常-公开课件.pptVIP

* 肝实质损伤 Liver cell damage ALT AST 胆汁郁积 Cholestasis γ-GT ALP 5’-NT 肝纤维化 hepatic fibrosis MAO PH 肝癌 liver cancer AFP ALP γ-GT AFU 肝胆疾病的临床酶学 * Bile Salts - Intestinal Natural Detergents: Bile acids are produced in the liver and secreted in the intestine via the gall bladder. Bile acids are oxidation products of cholesterol. First the cholesterol is converted to the trihydroxy derivative containing three alcohol groups. The end of the alkane chain at C # 17 is converted into an acid, and finally the amino acid, glycine is bonded through an amide bond. The acid group on the glycine is converted to a salt. The bile salt is called sodiumglycoholate. Another salt can be made with a chemical called taurine. The main function of bile salts is to act as a soap or detergent in the digestive processes. The major action of a bile salt is to emulsify fats and oils into smaller droplets. The various enzymes can then break down the fats and oils. QUES. Explain how bile salts work to emulsify fats. Talk about the polar and non-polar parts of the molecule. * 三、 肝性脑病hepatic encephalopathy 是各种严重的肝病（如：严重的肝功能不全）的并发症或终末表现，是以代谢紊乱为基础、临床以意识障碍和昏迷为主要表现的中枢神经系统功能紊乱的综合征。 Hepatic encephalopathy is a syndrome observed in patients with cirrhosis of the liver. It is characterized by personality changes, intellectual impairment, and a depressed level of consciousness. 1、概念（concept) * 2、临床表现 Clinical presentation Sleeping disorder Apathy Childishness Confusion Drowsiness 睡意 Coma * 3、病因Etiology 肝硬化（各种），大部分，肝炎后肝硬化最多见，门-体分流（手术或肝内自然分流） Cirrhosis (all kinds), most of liver cirrhosis, up to see the door - shunt (Natural intrahepatic or shunt surgery) 急性或爆发性肝功能衰竭：重症肝炎（病毒性、中毒性、药物性） Acute or fulminant hepatic failure : severe hepatitis (viral, toxic, drug-induced) 原发性肝癌、妊娠期急性脂肪肝、严重胆道感染 Primary liver cancer, acute fatty liver of pregnancy, severe biliary tract infection 各种肝病的终末期 A variety of end-stage liver disease * 4、诱因inducement 上消化道出血Upper gastrointestinal bleeding 感染infect