胆石病患者胆汁酸代谢轮廓分析

目的探讨胆石病患者与健康人群血清胆汁酸谱差异,分析其对胆石病的辅助诊断价值及可能的成石机制。方法选取2018年1月至2019年1月到重庆医科大学附属第一医院就诊的胆石病患者(n=33)及健康志愿者(对照组,n=51)共84例为研究对象。采用超高效液相色谱-串联质谱分析法同时检测胆石病患者和健康志愿者血清中15种胆汁酸的水平,并对检测所得到的数据进行多个变量的分析,从而建立胆石病的临床诊断模型,筛选出合适的胆汁酸生物标志物,并对血清中的生物标志物的统计学意义及诊断价值进行分析。结果成功构建出胆石病的正交偏最小二乘法判别分析(OPLS-DA)模型。2组甘氨鹅脱氧胆酸、鹅脱氧胆酸、牛磺熊脱氧胆酸、甘氨胆酸、牛磺脱氧胆酸、牛磺石胆酸、牛磺鹅脱氧胆酸、牛磺胆酸水平比较,差异均有统计学意义(P<0.05)。结论胆汁酸代谢轮廓对临床诊断胆石病有较大的应用价值,有望用于胆石病的早期诊断及鉴别诊断。

Analysis of the metabolic profile of bile acid in patients with cholelithiasis

Objective To investigate the difference of serum bile acid composition between patients with cholelithiasis and healthy people and to analyze its diagnostic value and possible stone-forming mechanism for cholelithiasis.Methods A total of 84 patients with cholelithiasis(n=33)and healthy volunteers(control,n=51)who visited the First Affiliated Hospital of Chongqing Medical University from January 2018 to January 2019 were recruited.Fifteen bile acids were quantified using high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).On the basis of analysis of muti-variables,the clinical diagnostic model for cholelithiasis had established,appropriate biomarkers of bile acids were screened out,the statistical significance and diagnostic value of biomarkers in serum were analyzed.Results The orthogonal partial least squares discriminant analysis(OPLS-DA)models of cholelithiasis were successfully constructed.The difference of glycine chenodeoxycholic acid,chenodeoxycholic acid,taurochordoxycholic acid,glycine,taurocholate,taurocholate,taurocholate,taurocholate between the two groups was statistically significant(P<0.05).Conclusion The metabolic profile of bile acid has great value in clinical diagnosis of cholelithiasis,which is expected to be used in the early diagnosis and differential diagnosis of cholelithiasis.