STUDIES ON BLOOD SPECTRUM : Ⅱ. EVALUATION OF BLOOD SPECTRUM AS THE MEANS OF DIAGNOSIS OF HEPATOBILIARY DISTURBANCES

The graphs of hepatic parenchma (CCF, Alb, Glob, and Ch.E) and biliaryobstruction (1 or 15-m Bil, Alk .P, Chol and Ph.t) which compose the blood spectrum (a system of graphical representation of chemical consituents of blood fpr The purpose of clinical diagnosis) were studied on 662 patients with hepatobiliary diseases and on 159 patients on whom biopsy of the liver was done. They were classified into the groups of patterns according to the shape of the lines connecting the points of estimation marked on the granguated lines relevant to the individual testa or chemical ingredients of blood: patterns N, n, d and D (graph of hepatic parenchma) and patterns N, n, w and 0 (graph of biliary obstruction) depending on the number ofabnormal results of the tests or ingredients being 0-1, 2, 3 and 4, respectively. The groups were further divided into subpatterns, taking into consideration the individual tests which shifted in the abnormal range. The graphs thus classified and divided were evaluated as a useful too for the derection of The damage to hepatic tissue and the biliary obstruction after they were carefully compared whit the clinical diagnosis, clinical course and hepatic histology (biopsy). The results are summarized as folows: 1)The graph of hepatic parenchyma: Groups N and n of the patterns referred to the slight hepatic damage, while groups d and D indicated the severer damages. Groups N →n→d→D were related to the hepatic damage which were increasingly severe in the order given. The graph of biliary obstruction: Groups N→n→w→0 corresponded with the increasingly disturbance in biliary outflow in the order listed. 2)The patterns belonging to the same group were equivalent in clinical significance. However, pattern .N of the group Ｎ (biliary obstruction) was the exception, because it was more often associated with the unequivocal disturbance in the biliary outflow, whereas other patterns include in this group generally indicated the unhindered passage of bile. Patterns N',N. and n: (biliary obstruction) were the contrary, being frequently of little significanse regarding the biliary obstruction, sinse they were also common in the diseases entailing the lipemia which was independent of the disturbed biliary out flow. 3)The feature of The hepatic damage and biliary obstruction suggested by the graphs agreed fairly well The histological picture of the liver obtained by needle biopsy. Grateful acknowledgements are due to Prof. Senji Uchino of the Department of Biochemistry, Kyoto University Shool of Medicine, for the preparation of this manuscript as well as to Prof. Susumu Shibata of the Depertment of Clinical Pathology, Yamaguchi Medical College, for his kind dierction throughout the course of this study.