乙型肝炎患者氨基酸代谢与同型半胱氨酸浓度变化分析  

The Amino Acid Metabolism and the Concentration Change of Homocystenine in Hepatitis B Patients

作　　者：郭平[1,2] 黄鑽 黄杰[1,2] 李键红[1,2] 王健[1,2] 杨敏[4] 

机构地区：[1]成都市第三人民医院检验科 [2]重庆医科大学附属成都第二临床学院,四川成都610031 [3]成都市第九人民医院,四川成都610015 [4]成都市第七人民医院,四川成都610041

出　　处：《昆明医学院学报》2011年第8期62-65,共4页Journal of Kunming Medical College

基　　金：四川省卫生厅课题基金资助项目(090048)

摘　　要：目的探讨氨基酸代谢及同型半胱氨酸浓度变化与乙型肝炎患者的关系,有助于临床医师根据疾病的特性制定合理的治疗方案.方法 96例临床确诊乙型肝炎患者,根据临床诊断分为无症状乙型肝炎携带者(ASC)、急性乙型肝炎(AHB)、慢性乙型肝炎(CHB)、肝硬化(LC)、肝细胞癌(HCC)5个疾病组为研究对象,30例体检健康组作为对照,通过自动生化仪、氨基酸检测仪和荧光定量PCR仪进行同型半胱氨酸(HCY)、血清谷丙氨酸转氨酶(ALT)、总胆红素(TBIL)、白蛋白(ALB)、氨基酸、乙型肝炎DNA载量(HBV DNA)等测定.结果 (1)乙型肝炎患者中支链氨基酸测定值明显低于体检健康组,而芳香族氨基酸测定值高于体检健康组,支链氨基酸与芳香族氨基酸比值降低(P<0.05);(2)乙型肝炎组与体检健康对照组TBIL、ALT、ABL、HCY、HBV DNA含量差异有统计学意义(P<0.05).(3)乙型肝炎患者不同组别HCY水平和氨基酸谱改变与TBIL、ALT、ABL、以及HBV DNA阳性检出率(%)相关.结论同型半胱氨酸水平及氨基酸的测定与疾病轻重有临床诊断价值,当联合TIBL、ALT、ABL和HBV DNA等相互补充更具临床诊断意义.Objective To discuss the relationship between the amino acid metabolism,the concentration change of homocystenie and the Hepatitis B patients,which can help the clinicians make the reasonable regimen according to the features of the certain disease.Methods 96 hepatitis B patients who are clinically diagnosed and grouped as Asymptomatic hepatitis B carriers（ASC）,Acute hepatitis B（AHB）,Chronic hepatitis B（CHB）,Liver Cirrhosis（LC）,Hepatocellular carcinoma（HCC）and 30 physically healthy individuals as the control were selected as the research objects.The serum levels of homocysteine（HCY）,alanine aminotransferase acid（ALT）,total bilirubin（TBIL）,albumin（ALB）,amino acids,and Hepatitis B DNA load（HBV DNA）were detected by the automatic biochemistry analyzer,the amino acid detector and the real-time qPCR.Results（1）The measured values of branched chain amino acid of the Hepatitis B patients were significantly lower than those of the healthy subjects,however,the measured values of aromatic amino acid of the Hepatitis B patients were higher,and the ratio of the branched chain amino acid and the aromatic amino acid decreased（P0.05）.（2）There was a statistically significant difference in the levels of TBIL,ALT,ABL,HCY and HBV DNA between the Hepatitis B patients and the healthy subjects.（3） The HCY levels of Hepatitis B patients in different groups and the change of aminogram arerelated to the positive detective ratio of TBIL,ALT,ABL and HBV DNA.Conclusion The levels of homocysteine and the assay of Amino acids have an important clinical diagnostic value in judging the condition of hepatitis B patients,and have more more clinical diagnosis meaning when combined with TIBL,ALT,ABL,HBV DNA.

关 键 词：乙型肝炎 同型半胱氨酸 氨基酸 肝功能 临床价值 

分 类 号：R575.1[医药卫生—消化系统]