肝炎及肝硬化患者血代谱及生物标记物相关性研究

Study on the correlation between hematologic genes and hematology in hepatitis and cirrhosis patients

目的探讨自身免疫性肝炎及原发性胆汁性肝硬化患者与健康人群血液代谢谱差异及生物标记物的相关性。方法选取2014年5月到2015年6月该院确诊为自身免疫性肝炎(AIH)患者42例作为AIH组,原发性胆汁性肝硬化(PBC)患者45例作为PBC组,选取50例健康体检者作为对照组。采用线性梯度超高效质谱分析法对研究对象血清中的代谢物进行检测。并对检测所得到的数据进行多个变量的分析,从而建立AIH以及PBC的临床诊断模型,并对该模型的临床效果进行探究,筛选出合适的生物标记物,并对各组血清之中的生物标记物的活动情况进行分析。结果通过PBC组与AIH组患者代谢图谱的差异,构建出诊断两种疾病的模型。AIH组和PBC组胆汁酸水平高于对照组,溶血卵磷脂、卵磷脂、鞘磷脂、脂肪酸在AIH组和PBC组中较低,苯丙氨酸在AIH组中水平高于对照组,差异均有统计学意义(P<0.05)。结论血清代谢谱分析技术在诊断AIH以及PBC方面有重要意义,有望推广到临床。

Objective To investigate the correlation between blood metabolites and biomarkers in patients with autoimmune hepatitis and primary biliary cirrhosis and healthy people.Methods A total of 42 patients with autoimmune hepatitis(AIH group)and 45 patients with primary biliary cirrhosis(PBC group)in the hospital from May 2014 to June 2015 were enrolled in this study,and 50 healthy subjects were selected as control group.The metabolites in serum were tested by linear gradient ultra-high performance mass spectrometry.On the basis of analysis of multi-variables,the clinical diagnostic model for autoimmune hepatitis and primary biliary cirrhosis had established and tested,appropriate biomarkers were screened out,and activities of the biomarkers in the serum were analyzed.Results Through the differences of the metabolic profiles of patients with primary biliary cirrhosis and autoimmune hepatitis,a model for the diagnosis of both diseases was constructed.Serum levels of bile acids in AIH group and PBC group were significantly higher than those in control group(P<0.05).Serum levels of AI,PGF,and the level of phenylalanine in AIH group and PBC group were higher than that in control group,the difference were statistically significant(P<0.05).Conclusion Serum metabolites plays an important role in diagnosis of autoimmune hepatitis and primary biliary cirrhosis,it is expected to be applied in clinical practice.