[Clinico-pathological studies of alcoholic liver disease, especially on the diagnostic significance of endogenous bile acid tolerance test].

: Endogenous bile acid tolerance test was performed in 88 patients with alcoholic liver disease and results obtained were compared with histological features in their liver biopsy specimens. An increase of serum fasting total bile acid (FTBA) and maximum total bile acid (MTBA) was closely reflected the degrees of hepatic fibrosis and they were seemed to be useful for differential diagnosis and clinical observation of the alcoholic liver disease. We have been reported the criteria of the grading for bile acid tolerance test at Inuyama Symposium in 1977. With the use of this criteria, we applied it to alcoholic liver disease. The results of bile acid tolerance test were normal in patients with ALF mild, fatty liver and no remarkable change, these were slightly abnormal in patients with ALF moderate and severe, these were severe abnormal in patients with ALC. Bile acid tolerance test is a sensitive liver function test. However, this method is too complex for clinical use. Therefore, we recommend to use the serum bile acid level at 60 minutes after the yolk loading (60min-TBA), because we found 60min-TBA was almost the same as MTBA and accurately reflect the liver morphology. So, we concluded measurement of FTBA and 60min-TBA were adequate, especially in outpatients, to evaluate the progress of alcoholic liver disease.