摘要目的 分析胆囊胆固醇性息肉和腺瘤性息肉患者胆囊胆汁中8种结合胆汁酸的浓度差异,筛选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1-6月行胆囊切除患者,根据病理结果分为胆固醇性息肉组(20例)和腺瘤性息肉组(10例);另外选取10例非胆囊疾病患者为对照组.取3组患者的胆囊胆汁,利用高效液相色谱-紫外检测法分析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8～ 500 μg/ml的浓度范围内线性良好,r值为0.9996 ～0.9999,最低检测限为3.90 ～ 7.81 μg/ml.腺瘤性息肉组胆囊胆汁中牛磺胆酸(TCA)浓度为(75±51) μg/ml,显著低于胆固醇性息肉组[(228±206) μg/ml,q=3.120,P=0.014]和对照组[(104±40) μg/ml,q=2.950,P=0.027],胆固醇性息肉组胆囊胆汁中牛磺鹅脱氧胆酸(TCDCA)浓度[(604 ±444) μg/ml]显著高于腺瘤性息肉组[(310±182) μg/ml,q=2.560,P=O.048]和对照组[(308 ±21) μg/ml,q =2.970,P=0.023].结论 胆固醇性息肉胆囊胆汁中TCA和TCDCA浓度高于腺瘤性息肉,有望成为胆囊息肉样病变患者的代谢性鉴别诊断标志物.

abstractsObjective To investigate the difference in conjugated bile acids in the gallbladder bile between gallbladder cholesterol polyps and adenomatous polyps patients,and screen the differential diagnosis-markers for polypoid lesions of gallbladder (PLG).Methods From January to June 2013,the 20 cholesterol polyps patients,10 adenomatous polyps patients and 10 patients without gallbladder diseases were enrolled.High performance liquid chromatography assay with ultraviolet detection was used to test 8 conjugated bile acids in gallbladder bile.Results The 8 conjugated bile acids were completely analyzed in 10 minutes,and the assay was liner in the range 8-500 μg/ml.The correlation coeffients for linear regression was from 0.9996-0.9999 and the detection limits ranged from 3.90-7.81 μg/ml.The level of taurocholic acid (TCA) in adenomatous polyps group ((75 ± 51) μg/ml) was significantly lower than that in the cholesterol polyps ((228 ± 206) μg/ml,q =3.120,P =0.014) and control groups ((104 ± 40) μg/ml,q =2.950,P =0.027).The level of taurochenodeoxycholic acid (TCDCA) in cholesterol polyps group ((604±444) μg/ml) was significantly higher than that in the adenomatous polyps ((310 ±182) μg/ml,q =2.560,P =0.048) and control groups ((308 ± 21) μg/ml,q =2.970,P =0.023).Conclusions The levels of TCA and TCDCA in the gallbladder biles in cholesterol polyps patients were higher than those in adenomatous polyps patients,which may be the differential diagnosis-markers for PLG.