摘要
目的:研究妊娠期肝内胆汁淤积症(ICP)患者血清中15种胆汁酸亚型的变化,实现ICP妊娠期内高胆汁酸血症(AHP)的鉴别诊断。方法:收集2017年1月至2018年10月于南京市妇幼保健院住院的AHP患者血清69例、ICP患者血清25例及正常孕妇血清30例。采用API 4500MD LC-MS/MS串联质谱仪测定血清标本中15种分型胆汁酸含量,包括胆酸(CA)、脱氧胆酸(DCA)、鹅脱氧胆酸(CDCA)、熊脱氧胆酸(UDCA)、石胆酸(LCA)、甘氨胆酸(GCA)、甘氨脱氧胆酸(GDCA)、甘氨鹅脱氧胆酸(GCDCA)、甘氨熊脱氧胆酸(GUDCA)、甘氨石胆酸(GLCA)、牛磺胆酸(TCA)、牛磺脱氧胆酸(TDCA)、牛磺鹅脱氧胆酸(TCDCA)、牛磺熊脱氧胆酸(TUDCA)及牛磺石胆酸(TLCA)。结果: API 4500MD LC-MS/MS串联质谱仪检测15种胆汁酸线性良好,AHP、ICP患者血清总胆汁酸含量均超出正常范围,15种分型胆汁酸均较正常孕妇高,其中ICP患者的GCA、TCA、TCDCA浓度高于AHP患者,差异有统计学意义( P <0.05),15种胆汁酸分型水平较正常孕妇升高,差异均有统计学意义( P <0.05)。结论: TBA在AHP诊断中具有重要意义,超高液相色谱串联质谱法能有效分离并定量检测人血清中15种胆汁酸水平。TBA的15个分型中甘氨胆酸、甘氨脱氧胆酸、鹅脱氧胆酸对鉴别AHP与ICP具有很好的诊断价值。
Objective: To study the changes of 15 kinds of bile acid subtypes in serum of patients with intrahepatic cholestasis of pregnancy (ICP) and normal control group,and to differentiate them from hyperbilirubinemia during pregnancy (AHP). Methods: Serum samples of 69 patients with AHP,25 patients with ICP and 30 normal pregnant women from Jan.2017 to Oct.2018 were collected.Determination of 15 types of bile acids in all serum samples by API 4500MD LC-MS/MS tandem mass spectrometry.Including cholic acid (CA),deoxycholic acid (DCA),goose deoxycholic acid (CDCA),ursodeoxycholic acid (UDCA),cholic acid (LCA),glycocholic acid (GCA),glycodeoxycholic acid (GDCA),glycodeoxycholic acid (GCDCA),glycodeoxycholic acid (GUDCA),glycodeoxycholic acid (GLCA),taurocholic acid (TCA),taurocholic acid (TDCA),taurogoose deoxycholic acid (TDCA).Cholic acid (TCDCA),taurous ursodeoxycholic acid (TUDCA) and taurine cholic acid (TLCA). Results: API 4500MD LC-MS/MS tandem mass spectrometer showed good linearity in detecting 15 kinds of bile acids.The serum total bile acids in patients with AHP and ICP were beyond the normal range.The serum total bile acids in 15 types of ICP were higher than those in normal pregnant women.The concentrations of GCA,TCA and TCDCA in patients with ICP were higher than those in patients with AHP,and the difference was significant ( P <0.05).The level of serum concentration in normal pregnant women was significantly higher than that in normal pregnant women( P < 0.05 ). Conclusions: TBA plays an important role in the diagnosis of AHP.Ultra-high performance liquid chromatography tandem mass spectrometry can effectively separate and quantitatively detect 15 kinds of bile acids in human serum.Glycocholicacid,glycodeoxycholic acid and goose deoxycholic acid in 15 types of TBA are of great diagnostic value in differentiating AHP from ICP.
作者
赵雪晴
陈辰
陈亚军
Zhao Xueqing;Chen Chen;Chen Yajun(Nanjing Maternity and Child Health Care Hospital,Nanjing 210009)
出处
《现代妇产科进展》
CSCD
北大核心
2019年第12期917-919,共3页
Progress in Obstetrics and Gynecology
关键词
妊娠期胆汁淤积症
妊娠期高胆汁酸血症
胆汁酸
胆汁酸亚型
Intrahepatic cholestasis of pregnancy
Asymptomatic hypercholanemia of pregnancy
Bile acid
Bile acid subtypes
