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目的用反相高效液相色谱(RPHPLC)测定妊娠肝内胆汁淤积症(ICP)患者血清9种甘氨结合胆汁酸和游离胆汁酸的浓度,建立ICP疾病的胆汁酸谱,以增加对ICP诊断的灵敏度和特异性。方法用柱前衍生RPHPLC法测定11例ICP患者,11例乙肝患者,11名正常孕妇血清9种胆汁酸浓度。结果ICP患者血清胆汁酸以甘氨胆酸(GCA)和甘氨鹅脱氧胆酸(GCDCA)增高为主,约为正常孕妇的20倍,GCA∶GCDCA约为3.5∶1;ICP患者血清游离胆汁酸的浓度与正常孕妇相似;ICP与乙型肝炎伴转氨酶轻中度增高的胆汁酸谱也不同。因而ICP患者的胆汁酸谱具有一定的特异性,可以对ICP进行诊断及与乙肝进行鉴别诊断。结论本研究在国内首次报道了ICP患者的特征胆汁酸谱,将有助于ICP的诊断和鉴别诊断。
Objective To determine the concentrations of nine glycine-bound bile acids and free bile acids in serum of patients with pregnancy-induced intrahepatic cholestasis (ICP) by reverse-phase high performance liquid chromatography (RPHPLC) Sensitivity and specificity. Methods The serum concentrations of nine bile acids in 11 patients with ICP, 11 patients with hepatitis B and 11 normal pregnant women were determined by precolumn derived RPHPLC. Results The serum bile acids in patients with ICP were mainly increased by GCA and GCDCA, which was about 20 times higher than that of normal pregnant women. The GCA: GCDCA was about 3.5:1. The serum free bile Acid concentrations are similar to those of normal pregnant women; ICP is also different from hepatitis B with mild to moderate increase in transaminases. Therefore, patients with ICP bile acid spectrum has a certain specificity, can diagnose ICP and hepatitis B differential diagnosis. Conclusion This study reported for the first time in China the characteristic bile acid profile of ICP patients, which will be helpful for the diagnosis and differential diagnosis of ICP.