血清胆汁酸谱在婴儿巨细胞病毒肝炎中的变化及其临床意义  

Changes of Serum Bile Acid Profile in infants with cytomegalovirus hepatitis and clinical significance

作　　者：刘丽 赵丽燕 李蓉蓉 李双杰[2] 周宇 LIU Li;ZHAO Liyan;LI Rongrong;LI Shuangjie;ZHOU Yu(Department of Pediatrics,Zhuji People’s Hospital of Zhejiang Province,Zhuji,Zhejiang 311800,China;Liver Disease Center of Hunan Children’s Hospital,Changsha,Hunan 410000,China;Department of Critical Care Medicine,Zhuji People’s Hospital of Zhejiang Province,Zhuji,Zhejiang 311800,China)

机构地区：[1]诸暨市人民医院儿科,浙江诸暨311800 [2]湖南省儿童医院肝病中心,湖南长沙410000 [3]诸暨市人民医院重症医学科,浙江诸暨311800

出　　处：《医药前沿》2022年第6期1-4,共4页Journal of Frontiers of Medicine

基　　金：浙江省医药卫生科技计划青年人才项目《胆汁酸谱和小儿巨细胞病毒性肝炎的关系研究》(2019RC298)。

摘　　要：目的:探讨婴儿巨细胞病毒(Cytomegalovirus,CMV)肝炎血清胆汁酸谱的变化,并分析其临床意义。方法:选取2019年1月—2021年8月诸暨市人民医院收治的1~3个月CMV肝炎患儿72例作为观察组,根据不同临床表型将其分为以下4个亚组:黄疸型肝炎组(24例)、胆汁淤积性肝炎组(18例)、无黄疸性肝炎组(16例)、亚临床性肝炎组(14例)。再选取同期健康体检婴儿60名作为对照组。检测两组血清胆汁酸谱水平[胆酸(CA)、鹅脱氧胆酸(CDCA)、熊脱氧胆酸(UDCA)、石胆酸(LCA)、脱氧胆酸(DCA)、甘氨胆酸(GCA)、甘氨石胆酸(GLCA)、甘氨熊脱氧胆酸(GUDCA)、甘氨鹅脱氧胆酸(GCDCA)、甘氨脱氧胆酸(GDCA)、牛磺石胆酸(TLCA)、牛磺熊脱氧胆酸(TUDCA)、牛磺鹅脱氧胆酸(TCDCA)、牛磺脱氧胆酸(TDCA)、牛磺胆酸(TCA)]。检测观察组治疗前、诱导期结束时、维持期结束时、疗程结束后1个月4个时期的胆汁酸谱水平。结果:①观察组血清CA、GCA、GUDCA、GCDCA、TUDCA、TCDCA、TCA水平均高于对照组,UDCA、LCA、DCA、GLCA水平均低于对照组(P<0.05)。②亚临床性肝炎组UDCA、GUDCA、GCDCA高于黄疸性肝炎组,CDCA、UDCA、LCA、DCA、GDCA高于胆汁淤积性肝炎组,CDCA、UDCA、GUDCA、GCDCA高于无黄疸性肝炎组(P<0.05)。③疗程结束后1个月CA、UDCA、GCA、DCA、GUDCA、GCDCA、TUDCA、TCDCA、TDCA、TCA水平均低于治疗前、诱导期和维持期结束时(P<0.05)。结论:CMV肝炎患儿存在胆汁酸代谢障碍,不同临床表型、不同病情阶段CMV肝炎患儿血清胆汁酸谱水平存在一定差异,结果为进一步相关代谢机制的研究提供理论依据。Objective To investigate the changes in serum bile acid profile of cytomegalovirus(CMV)hepatitis in infants,and to analyze its clinical significance.Methods 72 infants from 1 to 3 months with CMV hepatitis admitted to Zhiji People’s Hospital from January 2019 to August 2021 were selected as the observation group.According to different types of hepatitis,the infants were divided into the following four subgroups:jaundice hepatitis group(n=24),cholestasis hepatitis group(n=18),non-jaundice hepatitis group(n=16),and subclinical hepatitis group(n=14).60 infants with healthy physical examination during the same period were selected as the control group.Detect the serum bile acid profile levels of the two groups[cholic acid(CA),chenodeoxycholic acid(CDCA),ursodeoxycholic acid(UDCA),lithocholic acid(LCA),deoxycholic acid(DCA),glycocholic acid(GCA),glycocholic acid(GLCA),glycoursodeoxycholic acid(GUDCA),glycochenodeoxycholic acid(GCDCA),glycodeoxycholic acid(GDCA),taurocholic acid(TLCA),tauroursodeoxycholic acid(TUDCA),taurochenodeoxycholic acid(TCDCA),taurodeoxycholic acid(TDCA),taurocholic acid(TCA)].The bile acid profile levels of the observation group were detected in the pre treatment,at the end of the induction period,at the end of the maintenance period,and 1 month after the course of treatment.Results①The levels of serum CA,GCA,GUDCA,GCDCA,TUDCA,TCDCA and TCA in the observation group were higher than those in the control group,and the levels of serum UDCA,LCA,DCA,and GLCA were lower than those in the control group(P<0.05).②The levels of serum UDCA,GUDCA and GCDCA in the subclinical hepatitis group were higher than those in the jaundice hepatitis group,and CDCA,UDCA,LCA,DCA and GDCA were higher than those in the cholestasis hepatitis group,and CDCA,UDCA,GUDCA and GCDCA were higher than those in the non-jaundice hepatitis group(P<0.05).③The levels of serum CA,UDCA,GCA,DCA,GUDCA,GCDCA,TUDCA,TCDCA,TDCA,TCA at 1 month after the course of treatment were lower than those in the pre treatment and at the end of th

关 键 词：婴儿 小儿 巨细胞病毒 肝炎 胆汁酸谱 

分 类 号：R575.1[医药卫生—消化系统]