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Etiology and Pathogenesis of Marked Elevation of Serum Transaminase in Patients With Acute Gallstone Disease

机译：急性胆结石病患者血清转氨酶升高的病因和发病机制

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From 1980 through 1988, biliary surgery was performed in 197 patients with acute gallstone disease andconcomitant elevation of serum glutamic oxalacetic transaminase (SGOT) or serum glutamic pyruvictransaminase (SGPT) of over 300 Karmen units. In 137 patients, anatomic inspection and liver biopsywere performed during the acute stage of the disease. Impacted and floating bile duct stones were foundin 69 (50%) and in 43 (32%) of the 137 patients, respectively. The main liver histology was necrosis ofliver cells. After surgery, high serum transaminase fell rapidly with immediate recovery in 99% of thepatients. In the remaining 60 patients, their signs and symptoms settled soon after initial conservativetreatment and surgery was performed after an average time of 21 days. At laparotomy, impacted bileduct stones were found in 2 (3%) and liver histology revealed regeneration of liver cells.These findings suggest that marked elevation of serum transaminase in patients with acute gallstonedisease might be due to an acute inflammatory liver cell injury caused by impacted bile duct stones ormigrating stones, which would be transient and reversible after early resolution of the bile ductobstruction.
机译：从1980年到1988年，对197例急性胆结石病并伴有300多个卡门单位的血清谷氨酸草酰乙酸转氨酶（SGOT）或血清谷氨酸丙酮酸转氨酶（SGPT）升高的患者进行了胆道手术。在该病的急性期，对137例患者进行了解剖检查和肝活检。 137例患者中有69例（50％）和43例（32％）发现了受累和漂浮的胆管结石。肝的主要组织学是肝细胞坏死。手术后，高血清转氨酶迅速下降，有99％的患者立即恢复。在其余的60名患者中，他们的症状和体征在最初的保守治疗后很快就得到了缓解，平均在21天之后进行了手术。开腹手术中发现胆汁结石受累2个（3％），肝脏组织学检查显示肝细胞再生，这些结果表明急性胆结石病患者血清转氨酶显着升高可能是由于感染引起的急性炎症性肝细胞损伤胆管结石或迁移性结石，在胆管梗阻的早期解决后将是短暂的和可逆的。

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