CAJ | 학술논문

目的：通过分析胆囊胆固醇性息肉和腺瘤性息肉患者血清中8种结合胆汁酸的浓度差异，寻找胆固醇性息肉和腺瘤性息肉的代谢性鉴别诊断标志物。方法采集2013年3至11月行胆囊切除的患者，根据病理结果分为胆固醇性息肉组（18例）、腺瘤性息肉组（9例），胆囊结石患者为对照组（20例）。取3组患者的空腹静脉血清，利用高效液相色谱-紫外检测法分析血清中8种结合性胆汁酸的含量。结果8种结合胆汁酸在10 min内分离完全，各胆汁酸标准曲线在3．91～500．00 mg/L浓度范围内线性良好，r值为0．995～0．999，最低检测限为3．91～7．81 mg/L。腺瘤性息肉组血清中甘氨胆酸（GCA）浓度为（3．48±1．66） mg/L，显著高于胆固醇性息肉组[（2．16±0．71） mg/L， q＝5．182，P＝0．001]和对照组[（2．15±0．45） mg/L，q＝5．313，P＝0．001]。腺瘤性息肉组血清中甘氨鹅脱氧胆酸（GCDCA）浓度为（12．67±1．74） mg/L，显著高于胆固醇性息肉组[（10．53±3．04） mg/L， q＝3．253，P＝0．026]和对照组[（10．72±1．58） mg/L，q＝3．015，P＝0．038]。腺瘤性息肉组血清中牛磺鹅脱氧胆酸（TCDCA）浓度为（6．79±2．90） mg/L，显著高于胆固醇性息肉组[（4．47±2．35） mg/L， q＝3．412，P＝0．020]和对照组[（4．72±2．11） mg/L，q＝3．091，P＝0．034]。结论 GCA、GCDCA 和TCDCA在腺瘤性息肉患者血清中的浓度显著高于胆固醇性息肉患者，有望成为胆囊息肉样病变患者的代谢性鉴别诊断标志物。
목적：통과분석담낭담고순성식육화선류성식육환자혈청중8충결합담즙산적농도차이，심조담고순성식육화선류성식육적대사성감별진단표지물。방법채집2013년3지11월행담낭절제적환자，근거병리결과분위담고순성식육조（18례）、선류성식육조（9례），담낭결석환자위대조조（20례）。취3조환자적공복정맥혈청，이용고효액상색보-자외검측법분석혈청중8충결합성담즙산적함량。결과8충결합담즙산재10 min내분리완전，각담즙산표준곡선재3．91～500．00 mg/L농도범위내선성량호，r치위0．995～0．999，최저검측한위3．91～7．81 mg/L。선류성식육조혈청중감안담산（GCA）농도위（3．48±1．66） mg/L，현저고우담고순성식육조[（2．16±0．71） mg/L， q＝5．182，P＝0．001]화대조조[（2．15±0．45） mg/L，q＝5．313，P＝0．001]。선류성식육조혈청중감안아탈양담산（GCDCA）농도위（12．67±1．74） mg/L，현저고우담고순성식육조[（10．53±3．04） mg/L， q＝3．253，P＝0．026]화대조조[（10．72±1．58） mg/L，q＝3．015，P＝0．038]。선류성식육조혈청중우광아탈양담산（TCDCA）농도위（6．79±2．90） mg/L，현저고우담고순성식육조[（4．47±2．35） mg/L， q＝3．412，P＝0．020]화대조조[（4．72±2．11） mg/L，q＝3．091，P＝0．034]。결론 GCA、GCDCA 화TCDCA재선류성식육환자혈청중적농도현저고우담고순성식육환자，유망성위담낭식육양병변환자적대사성감별진단표지물。
Objective To explore the concentration differences of eight conjugated bile acids between patients of cholesterol polyps and adenomatous polyps and determine the differential diagnosis markers for polypoid lesions of gallbladder ( PLG ) .Methods During the period of March 2013 to November, 18 cholesterol polyps patients, 9 adenomatous polyps ones and 20 simple gallstone disease ones were enrolled.High performance liquid chromatography with ultraviolet detection was used to test 8 conjugated bile acids in sera.Results A total of 8 conjugated bile acids were completely dissociated within 10 minutes and the assay was liner in the range of 3.91 to 500.00 mg/L.The correlation coefficients for linear regression were from 0.995 to 0.999 and the detection limits ranged from 3.91 to 7.81 mg/L.The serum level of glycocholic acid (GCA) in adenomatous polyps group (3.48 ±1.66) mg/L was significantly higher than that in cholesterol polyps group ((2.16 ±0.71) mg/L, q=5.182, P=0.001) and control group ((2.15 ±0.45) mg/L, q =5.313, P =0.001).The serum level of glycochenodeoxycholic acid ( GCDCA) in adenomatous polyps group ( 12.67 ±1.74 ) mg/L was significantly higher than that in cholesterol polyps group ((10.53 ±3.04) mg/L, q=3.253, P=0.026) and control group ((10.72 ± 1.58) mg/L, q =3.015, P =0.038 ) .The serum level of taurochenodeoxycholic acid ( TCDCA ) in adenomatous polyps group ((6.79 ±2.90) mg/L) was significantly higher than that in cholesterol polyps group ((4.47 ±2.35) mg/L, q=3.412, P=0.020) and control group ((4.72 ±2.11) mg/L q=3.091, P=0.034).Conclusion The serum levels of GCA, GCDCA and TCDCA in adenomatous polyps patients are higher than those in cholesterol polyps counterparts.And these markers may aid the differential diagnosis of PLG.