非酒精性脂肪肝患者血清胆汁酸亚组分的研究  

Relationship between bile acid sub components and traditional biochemical indicators and nonalcoholic fatty liver

作　　者：杜金龙 张昊宇 刘振东 刘淑梅[1] 杜海燕[1] 唐春燕 李卓敏 谭延国[1] DU Jinlong;ZHANG Haoyu;LIU Zhendong;LIU Shumei;DU Haiyan;TANG Chunyan;LI Zhuomin;TAN Yanguo(Department of Clinical Laboratory,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Laboratory Medicine,Capital Medical University,Beijing 100038,China;Beijing Metz Mass Spectrometry Biotechnology,Beijing 102629,China)

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学医学检验系,北京100038 [3]北京梅斯质谱生物科技有限责任公司,北京102629

出　　处：《国际检验医学杂志》2025年第7期786-790,共5页International Journal of Laboratory Medicine

基　　金：首都医科大学教育教学改革研究课题项目(2023JYY266)。

摘　　要：目的 探讨非酒精性脂肪肝(NAFLD)患者血清中22种胆汁酸亚组分、17项常规生化指标的变化,以及单独或联合检测上述指标对NAFLD的诊断作用。方法 选取168例NAFLD患者(NAFLD组)及216例非NAFLD表观健康者(非NAFLD组),分别使用液相色谱-串联质谱法测定其血清胆汁酸亚组分,全自动生化分析仪检测常规生化指标。结果 NAFLD组和非NAFLD组12项胆汁酸亚组分、12项常规生化指标水平比较,差异有统计学意义(P<0.05)。相比常规生化指标,胆汁酸亚组分受体重指数(BMI)的影响更小。联合3项胆汁酸亚组分[牛磺酸结合型胆汁酸包括牛磺胆酸(TCA)、牛磺脱氧胆酸钠(TDCA)、熊去氧胆酸(UDCA)]与3项常规生化指标[丙氨酸氨基转移酶(ALT)、5′-核苷酸酶(5′-NT)、小而密低密度脂蛋白胆固醇(sd-LDL-C)]诊断NAFLD的曲线下面积最大,为0.810。结论 NAFLD患者血液中有12种胆汁酸亚组分发生了变化,且将胆汁酸亚组分与常规生化指标联合检测可在一定程度上提高对NAFLD的诊断效能。Objective To investigate the changes of 22 bile acid sub components and 17 traditional biochemical indicators in serum of patients with non-alcoholic fatty liver disease(NAFLD),and the diagnostic value of detecting the above indicators alone or in combination for NAFLD.Methods A total of 168 NAFLD patients(NAFLD group) and 216 non-NAFLD apparently healthy individuals(non-NAFLD group) were selected,bile acid sub components were determined by liquid chromatography tandem mass spectrometry,and traditional biochemical indicators were detected by automatic biochemical analyzer.Results There were statistically significant differences in the levels of 12 bile acid sub components and 12 traditional biochemical indicators between NAFLD group and non-NAFLD group(P<0.05).Compared to traditional biochemical indicators,bile acid sub components were less affected by body mass index(BMI).The area under the curve for diagnosing NAFLD by combining three bile acid sub components [taurocholic acid(TCA),sodium taurodeoxycholate(TDCA),and tauroursodeoxycholic acid(UDCA)] with three traditional biochemical indicators [alanine aminotransferase(ALT),5′Nucleotidase(5′-NT),and small and dense low-density lipoprotein cholesterol(sd-LDL-C)] was the largest,which was 0.810.Conclusion Twelve kinds of bile acid sub components in the blood of NAFLD patients have changed,and the combined detection of bile acid sub components and traditional biochemical indicators could improve the diagnostic efficacy of NAFLD to a certain extent.

关 键 词：液相色谱-串联质谱 胆汁酸亚组分 非酒精性脂肪肝 体重指数 

分 类 号：R575.5[医药卫生—消化系统]