中国普外基础与临床杂志

中国普外基础与临床杂志

以核磁共振方法测定胆囊结石患者的氨基酸谱及糖代谢谱的初步临床研究

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目的 运用基于核磁共振(NMR)的代谢组学研究方法,探索无胆囊结石的健康人/肝移植供体和胆囊结石患者的血清和胆汁中代谢物质的差别,分析与胆囊结石发病机制相关的代谢变化。 方法 前瞻性收集 2016 年 3 月至 2016 年 12 月期间于四川大学华西医院接受腹腔镜胆囊切除术的 19 例胆囊结石患者的血清标本(17 例)和胆汁标本(19 例),同时收集同期于四川大学华西医院行体检的 10 位健康体检者的血清标本,以及 15 例肝移植供体的胆汁标本,采用1H-NMR 代谢组学技术比较无胆囊结石的健康人/肝移植供体和胆囊结石患者的血清和胆汁中代谢物质的差异。 结果 与无胆囊结石的健康人比较,胆囊结石患者血清中的缬氨酸、丙氨酸、赖氨酸、谷氨酰胺、谷氨酸、丙酮酸、肌酸酐、胆碱、α-葡萄糖、β-葡萄糖、酪氨酸、组氨酸及次黄嘌呤的浓度均明显降低(P<0.05),而乳酸盐、乙酰乙酸及 1, 2-丙二醇的浓度均明显升高(P<0.05)。与肝移植供体比较,胆囊结石患者胆汁中的牛磺酸结合的胆汁酸、甘氨酸结合的胆汁酸、胆碱及磷脂酰胆碱的浓度均明显降低(P<0.05),而胆固醇的浓度明显升高(P<0.05)。 结论 胆囊结石患者的血清和胆汁代谢物和无胆囊结石的健康人/肝移植供体存在明显差异,1H-NMR 代谢组学方法有助于研究胆囊结石的发病机制。

Objective The method of metabonomics based on nuclear magnetic resonance (NMR) imaging was used to explore the difference in metabolites of serum and bile, and to analyze the metabolic variation related to the pathogenesis of gallbladder stones between normal people/liver transplantation donors and patients with gallbladder stones. Methods Prospectively collected the serum samples (17 cases) and bile samples (19 cases) in 19 patients with gallbladder stones who underwent surgery in West China Hospital form March 2016 to December 2016, as well as the serum samples of 10 healthy persons and the bile samples of 15 liver transplantation donors at the same time period. The differences of metabolites in the blood and bile in these 3 groups were compared by using 1H-NMR metabonomics technology and chemometric methods. Results The concentrations of valine, alanine, lysine, glutamine, glutamate, pyruvate, creatinine, choline, alpha-glucose, beta-glucose, tyrosine, histidine, and hypoxanthine in serum of patients with gallbladder stones decreased significantly, comparing with those of healthy people without gallbladder stones (P<0.05), while 1, 2-propanediol, acetoacetate, and lactate increased significantly in the serum of patients with gallbladder stones (P<0.05). The concentrations of taurine conjugated bile acids, glycine conjugated bile acids, choline, and phosphatidylcholine decreased significantly in the bile of patients with gallbladder stones when compared with those of liver transplantation donors (P<0.05), while cholesterol increased significantly in the bile of patients with gallbladder stones (P<0.05). Conclusions There are significant differences of the serum and bile metabolites between patients with gallbladder stones and healthy men without gallbladder stones/liver transplantation donors. 1H-NMR metabonomics is helpful to investigate the pathogenesis of gallbladder stones.

关键词: 胆囊结石; 核磁共振; 代谢组学; 血清; 胆汁

Key words: gallbladder stones; nuclear magnetic resonance; metabonomics; serum; bile

引用本文: 马文杰, 陈巍巍, 杨琴, 李全生, 李富宇. 以核磁共振方法测定胆囊结石患者的氨基酸谱及糖代谢谱的初步临床研究. 中国普外基础与临床杂志, 2018, 25(4): 401-409. doi: 10.7507/1007-9424.201709077 复制

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