[Studies on pruritus in obstructive jaundice cases with special references to serum bile acid fractions]

Abstract

About, 22 cases with pruritus and 18 cases without pruritus of obstructive jaundice, serum bile acids were analysed quantitatively by high performance liquid chromatography (HPLC) before and after biliary decompression for the study on the relationship between pruritus and non-pruritus group. Analysis was also carried out on 11 cases with normal liver function as the control group. And 15 kinds of bile acids were as followed: unconjugates (ursodeoxycholic: UDCA, cholic: CA, chenodeoxycholic: CDCA, deoxycholic: DCA, lithocholic acid: LCA), glycine conjugates (Gly-UDCA, Gly-CA, Gly-CDCA, Gly-DCA, Gly-LCA) and taurine conjugates (Tau-UDCA, Tau-CA, Tau-CDCA, Tau-DCA, Tau-LCA). Data was analysed by t-test statistically. [I] Before biliary decompression (1) No significant difference was observed between the pruritus group and non-pruritus group about total bile acid level, total unconjugates level and CA/CDCA ratio. (2) On total glycine-conjugates level the pruritus group was significantly lower than the non-pruritus group, that level was about 3/5. Similarly on Gly-CA level was about 2/3, on Gly-CDCA level was about 1/2. (3) By contraries on total taurine-conjugates level the pruritus group was significantly high as compared with the non-pruritus group, that level was about two times. Similarly on Tau-CA and Tau-CDCA levels were about two times. (4) From there results on glycine/taurine ratio (G/T) of total bile acids pruritus group was significantly low as compared with the non-pruritus group, that level was about 1/3. Similarly on G/T ratio of CA level was about 2/5 and on G/T ratio of CDCA was about 1/3. (5) As for various unconjugates, UDCA level was significantly high in pruritus group as compared with non-pruritus group. [II] After biliary decompression No significant difference was shown in the composition of serum bile acids between the pruritus group and the non-pruritus group. These studies showed that the pruritus in the obstructive jaundice cases stood in a certain relation to the increase of taurine-conjugates, especially taurine-conjugated CA and taurine-conjugated CDCA, moreover increase of unconjugated UDCA.