胆红素作为人体的一种重要内源性物质,是临床诊断黄疸的主要依据,也是肝功能的重要指标。本文在简述胆红素代谢过程、代谢动力学及代谢异常的基础上,重点对有机阴离子转运多肽(organic anion transport polypeptide,OATP)和多药耐药相关蛋白(multidrugassociated protein,MRP)等转运体介导的胆红素转运、PXR和CAR等核受体对UGT1A1介导的胆红素代谢调控、药物对胆红素代谢的抑制和诱导,及其与胆红素相关病症关系等方面的最新进展进行归纳和总结,为进一步研究和揭示黄疸、高胆红素血症、新生儿黄疸等胆红素相关病症的发生原因和发生机制提供参考,并为其诊断、预防和治疗提供最新科学依据。
As an essential endogenous substance in human body,bilirubin is a main criterion in clinical diagnosis of jaundice,and is also an important index in assessment of liver function.In this article,we briefly reviewed advances in metabolic process,kinetics and disorder of bilirubin,focused on describing organic anion transport polypeptide (OATP) and multidrugassociated protein (MRP)mediated transport of bilirubin,regulation of the nuclear receptor PXR and CAR on UGT1A1mediated metabolism of bilirubin,and inhibition and induction of drugs on metabolism of bilirubin,as well as their correlation with bilirubinrelated disease.The aim of this paper is to provide a reference for further exploring and disclosing the etiology and pathogenesis of bilirubinrelated malady,e.g.jaundice,hyperbilirubinemia,neonatal jaundice,and provide the latest scientific evidence for diagnosis,prevention and treatment of the disease.