论文部分内容阅读
目的探讨小儿先天性胆管扩张症血清胆汁酸谱的特点及其意义。方法建立人类已知全部15种胆汁酸液相色谱串联质谱定量检测方法,对15例先天性胆管扩张症患儿术前及术后1周、10例术后1年的空腹血清进行胆汁酸定量检测。结果患儿术前血清总胆汁酸(TBA)、牛黄胆酸(TC)和脱氧胆酸(DC)浓度异常升高,而胆酸(CA)、鹅脱氧胆酸(CDC)和熊脱氧胆酸(UDC)浓度降低;术前血清牛黄型胆汁酸和DC的百分含量升高,牛黄型和甘氨型胆汁酸比值(T/G)升高,而UDC百分含量下降。肝纤维化较重组患儿TBA和DC浓度以及DC百分含量高于轻度组。这些异常在根治术后1年内逐渐恢复正常。结论先天性胆管扩张症患儿存在血清胆汁酸谱异常,可能与继发性肝脏损伤程度有关。根治术后这些异常的恢复需较长时间。
Objective To investigate the characteristics and significance of serum bile acid profile in children with congenital bile duct dilatation. Methods Fifteen human known bile acid liquid chromatography-tandem mass spectrometry quantitative detection methods were established. Fifteen cases of congenital bile duct dilatation in children with preoperative and postoperative 1 week, 10 cases of postoperative 1 year fasting serum bile acid quantitative Detection. Results The levels of total bile acid (TBA), taurocholic acid (TC) and deoxycholic acid (DC) were abnormally elevated in children before operation. However, the levels of bile acid (CA), chenodeoxycholic acid (CDC) (UDC). Preoperative serum concentration of bovine and bile acids and DC increased, but the ratio of bovine to bile acid (T / G) increased while the percentage of UDC decreased. Children with severe liver fibrosis TBA and DC concentrations and DC percentage higher than the mild group. These abnormalities gradually returned to normal within 1 year after radical operation. Conclusion There is abnormal serum bile acid in children with congenital bile duct dilatation, which may be related to the degree of secondary liver injury. After radical surgery these abnormal recovery takes a long time.