全身放射治疗患者血浆胆汁酸代谢变化的研究  

Study on Plasma Bile Acid Metabolism of Total Body Irradiation Patients

作　　者：徐超 吴涵旭 王畅[1] 吴小津[2] 许愿[2] XU Chao;WU Han-xu;WANG Chang;WU Xiao-jin;XU Yuan(School of Radiation Medicine and Protection,Medical College of Soochow University,State Key Laboratory of Radiation Medicine and Protection,School of Radiation Medicine and Protection,Soochow University,Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions,Suzhou,Jiangsu,215123,China;the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学医学部放射医学与防护学院,省部共建"放射医学与辐射防护"国家重点实验室,江苏省高校放射医学协同创新中心,江苏苏州215123 [2]苏州大学附属第一医院,江苏苏州215006

出　　处：《中国血液流变学杂志》2019年第2期130-135,共6页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(81773361);江苏省高校优势学科建设工程资助项目。

摘　　要：目的 利用液相色谱-质谱联用(LC-MS)技术对造血干细胞移植(HSCT)患者全身放射治疗(TBI)前后的血浆胆汁酸水平的变化进行分析,为揭示电离辐射引起的放射性肠损伤发病机制提供实验依据.方法 对36 例HSCT患者TBI前后血浆中的胆汁酸进行LC-MS/MS定量分析.结果 TBI后,血浆牛磺胆酸(TCA)从(5.00±0.45)%升至(6.91±0.52)%,甘氨胆酸(GCA)从(9.94±0.78)%升至(14.75±1.31)%,甘氨酸脱氧胆酸(GUDCA)从(50.46±2.20)%降至(40.86±2.41)%,牛磺熊脱氧胆酸(TUDCA)从(2.78±0.24)%降至(1.78±0.28)%,胆汁酸分类后,初级胆汁酸由(17.09±1.18)%升至(23.01±1.49)%,次级胆汁酸由(82.91±1.18)%降至(76.99±1.49)%,二羟基化胆汁酸由(79.00±1.37)%降至(72.80±1.50)%,三羟基化胆汁酸由(21.00±1.37)%升至(27.20±1.50)%,以上差异均有统计学意义(P<0.05).结论 HSCT患者TBI前后血浆胆汁酸比例水平和疏水性(或亲水性)出现显著变化,提示这可能与辐射导致的胆汁酸合成与重吸收障碍有关.Objective To provide experimental basis for revealing the pathogenesis of radiation-induced intestinal injury by analyzing the levels in plasma bile acids of hematopoietic stem cell transplantation (HSCT) patients before and after total body irradiation (TBI). Methods Bile acid analysis based on LC-MS/MS was performed in plasma of 36 HSCT patients before and after TBI. Results After TBI, TCA increased from (5.00±0.45) % to (6.91±0.52) %, GCA increased from (9.94±0.78) % to (14.75±1.31) %, GUDCA decreased from (50.46±2.20) % to (40.86±2.41) %, TUDCA decreased from (2.78±0.24) % to (1.78±0.28) %. After classification, primary bile acids increased from (17.09±1.18) % to (23.01±1.49) %, secondary bile acids decreased from (82.91±1.18) % to (76.99±1.49) %, dihydroxy bile acids decreased from (79.00±1.37) % to (72.80±1.50) %, and trihydroxy bile acids increased from (21.00±1.37) % to (27.20±1.50) %. The above differences were statistically significant (P<0.05). Conclusion Before and after TBI, significant changes in HSCT patients' plasma bile acid including the proportion and the hydrophobicity (or hydrophilicity) may be related to radiation-induced bile acid synthesis and reabsorption disorders.

关 键 词：全身放射治疗 胆汁酸 液相色谱-质谱联用技术 放射性肠损伤 胆汁酸吸收不良 

分 类 号：R730.55[医药卫生—肿瘤]