中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2009年
6期
371-375
,共5页
印其友%肖现民%李昊%吕志葆%郑继翠%陈莲%周以明%李水军%刘罡一%贾晶莹%余琛
印其友%肖現民%李昊%呂誌葆%鄭繼翠%陳蓮%週以明%李水軍%劉罡一%賈晶瑩%餘琛
인기우%초현민%리호%려지보%정계취%진련%주이명%리수군%류강일%가정형%여침
胆管疾病%胆汁酸类和盐类%色谱法,液相%胆汁
膽管疾病%膽汁痠類和鹽類%色譜法,液相%膽汁
담관질병%담즙산류화염류%색보법,액상%담즙
Bile duct diseases%Bile acids and salts%Chromatography,Liquid%Bile
目的 探讨小儿先天性胆管扩张症囊肿内胆汁中胆汁酸谱的特点及其意义.方法 通过建立人类已知的全部15种胆汁酸改良的液相色谱串联质谱定量检测方法 ,以我院2002年10月至2004年6月收治小儿先天性胆管扩张症(CBD)16例为研究对象,其中男11例,女5例,年龄11～134个月,平均(44.8±24.6)个月,术前B超和(或)CT、术中胆道造影确诊为先天性胆管扩张症.对16例先天性胆管扩张症囊肿内胆汁进行胆汁酸定量检测.结果 先天性胆管扩张症囊肿内总胆汁酸的浓度与对照组比较明显降低,组成胆汁酸谱的各种胆汁酸与对照组比较相应减少,未见致癌性胆酸浓度增高.儿童胆汁中甘氨熊脱氧胆酸含量较高,总胆汁酸的降低与肝纤维化程度呈正相关.结论 先天性胆管扩张症患儿存在胆汁酸代谢异常,可能与肝脏继发性损伤程度有关,异常的胆汁酸谱可能与胆结石的发生相关.
目的 探討小兒先天性膽管擴張癥囊腫內膽汁中膽汁痠譜的特點及其意義.方法 通過建立人類已知的全部15種膽汁痠改良的液相色譜串聯質譜定量檢測方法 ,以我院2002年10月至2004年6月收治小兒先天性膽管擴張癥(CBD)16例為研究對象,其中男11例,女5例,年齡11～134箇月,平均(44.8±24.6)箇月,術前B超和(或)CT、術中膽道造影確診為先天性膽管擴張癥.對16例先天性膽管擴張癥囊腫內膽汁進行膽汁痠定量檢測.結果 先天性膽管擴張癥囊腫內總膽汁痠的濃度與對照組比較明顯降低,組成膽汁痠譜的各種膽汁痠與對照組比較相應減少,未見緻癌性膽痠濃度增高.兒童膽汁中甘氨熊脫氧膽痠含量較高,總膽汁痠的降低與肝纖維化程度呈正相關.結論 先天性膽管擴張癥患兒存在膽汁痠代謝異常,可能與肝髒繼髮性損傷程度有關,異常的膽汁痠譜可能與膽結石的髮生相關.
목적 탐토소인선천성담관확장증낭종내담즙중담즙산보적특점급기의의.방법 통과건립인류이지적전부15충담즙산개량적액상색보천련질보정량검측방법 ,이아원2002년10월지2004년6월수치소인선천성담관확장증(CBD)16례위연구대상,기중남11례,녀5례,년령11～134개월,평균(44.8±24.6)개월,술전B초화(혹)CT、술중담도조영학진위선천성담관확장증.대16례선천성담관확장증낭종내담즙진행담즙산정량검측.결과 선천성담관확장증낭종내총담즙산적농도여대조조비교명현강저,조성담즙산보적각충담즙산여대조조비교상응감소,미견치암성담산농도증고.인동담즙중감안웅탈양담산함량교고,총담즙산적강저여간섬유화정도정정상관.결론 선천성담관확장증환인존재담즙산대사이상,가능여간장계발성손상정도유관,이상적담즙산보가능여담결석적발생상관.
Objective To investigate the changes of bile acids in children suffering from thole-doehal cysts (CBD). Methods The bile from the choledochal cysts of 16 children was taken during op-eration. The samples were analyzed with Liquid Chromatography-Eleetrospray Tandem Mass Spec-trometry (LC-MS/MS). The levels of the bile acids including 15 unconjugated,glycine and taurine-con-jugated isomeric forms of bile acids were determined. Results The concentrations of total bile acids (TBA) declined significantly,and so did all forms of bile acids. No bile acid with carcinogenesis poten-tial was found to be elevated. The portion of glycoursodeoxycholic acid(GUDC) with CBD was de-creased,which had not been reported previously in children. The decrease of concentrations of TBA corre-lated with the severity of hepatic cirrhosis in these children. Conclusions The bile acids from CBD children was abnormal This may be related to the severity of hepatic cirrhosis and result in gallstone formation.
