The sulfated and nonsulfated bile acids in urine were determined in 28 infants with cholestasis, including 14 patients with neonatal hepatitis and 14 patients with biliary atresia. The mean age of the group with neonatal hepatitis was 80 days, ranging from 32 days to 111 days, and that of the group with biliary atresia was 51 days, ranging from 28 to 79 days. The major bile acids were cholic acid and chenodeoxycholic acid, and nonsulfated cholic acid was excreted predominantly. In the group of neonatal hepatitis, the values of nonsulfated cholic acid, nonsulfated chenodeoxycholic acid, sulfated cholic acid and sulfated chenodeoxycholic acid were 16.40±14.25, 1.49±1.11, 0.72±0.61 and 1.46±0.82mg per day, respectively. In the group of biliary atresia, these were 8.96±6.19, 0.90±0.51, 0.58±0.26 and 1.43±0.88mg per day, respectively. However, there was no significant difference in values of urinary bile acids between the two groups. In elder children and adults with cholestasis, the values of nonsulfated cholic acid, nonsulfated chenodeoxycholic acid, sulfated cholic acid and sulfated chenodeoxycholic acid were 39.43±25.29, 13.37±11.12, 10.92±6.21 and 25.54±12.89mg per day, respectively. No predominancy of nonsulfated cholic acid was found. To compare the urinary bile acid pattern of infants with cholestasis with that of elder children and adults with cholestasis, urinary bile acid was determined in terms of per mg creatinine. In the group of infants with neonatal hepatitis or biliary atresia, nonsulfated cholic acid was excreted in larger amounts than in the group of elder children and adults with cholestasis (
p<0.05), and sulfated chenodeoxycholic acid was excreted less than in the group of elder children and adults with cholestasis (
p<0.01). Small peaks were recognized on the chromatograms, one of which was identified as 3β-hydroxy-5-cholenoic acid in many cases. Besides, a small peak were found in trace amount in a case with fatal intrahepatic cholestasis, which has relative retention time of 3.04.
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