Objective:Explore the diagnostic value of total bile acids/platelets in HBV related liver fibrosis.Methods:160 patients with chronic HBV infection admitted to the Infection Department of the First Affiliated Hospital ...Objective:Explore the diagnostic value of total bile acids/platelets in HBV related liver fibrosis.Methods:160 patients with chronic HBV infection admitted to the Infection Department of the First Affiliated Hospital of Hainan Medical College from February 2021 to December 2022 were selected.They were divided into two groups based on the degree of liver fibrosis detected by liver biopsy:significant liver fibrosis group and non-significant liver fibrosis group.The total bile acid/blood platelet levels and their correlation with liver fibrosis in the two groups were compared and observed,and the efficacy of other non-invasive liver fibrosis diagnostic models was evaluated.Results:(1)Compared with the non-significant liver fibrosis group,the significant liver fibrosis group showed an increase in total bile acid levels,a decrease in platelet levels,and a significant increase in total bile acid/platelet levels(P<0.05).(2)Platelets decrease with the increase of liver fibrosis degree,total bile acids increase with the increase of liver fibrosis degree,and total bile acids/platelets increase with the increase of liver fibrosis degree.(3)The area under the curve(AUC)of total bile acid/platelet,APRI,FIB-4,and elastography in diagnosing the degree of liver fibrosis were 0.69,0.57,0.56,and 0.68,respectively.Conclusions:The diagnostic efficacy of total bile acids/platelets in diagnosing HBV related liver fibrosis is no less than that of other liver fibrosis diagnostic methods,and it is non-invasive,simple,and convenient,which is worthy of further clinical promotion and validation.展开更多
Aims: The abnormal increase of bile acid is found in intrahepatic cholestasis of pregnancy (ICP). It also can be observed the damage of placental tissue in ICP. The aim of this study was to find the associations of th...Aims: The abnormal increase of bile acid is found in intrahepatic cholestasis of pregnancy (ICP). It also can be observed the damage of placental tissue in ICP. The aim of this study was to find the associations of the bile acid in umbilical vein and the damage of placental tissue. Methods: Thirty women diagnosed with ICP and fifty normal pregnant women between September 2015 and September 2017 at Nanshan District Maternity & Child Healthcare Hospital of Shenzhen were included in this study. The glycocholic acid (GA), total bile acids (TBA), total bilirubin (TB), direct bilirubin (DB) and albumin level in umbilical vein were measured by cycle enzyme method in ICP and control group. The placental damage was analyzed by morphologic study using hematoxylin dyes in two groups. The correlation between the level of the bile acid in the umbilical vein and the damage of the placenta was assessed using SPSS software. Results: The GA, TBA, TB, DB and albumin level in umbilical vein were significantly higher in ICP than those of pregnant women, respectively. The placental villis were expanded and the structure was destroyed in ICP. The vessel was damaged and the cell trophoblast hyperplasia in ICP. It also can be seen that there was obvious nodules and a typical fibrous necrotic substance in ICP but not in control group. There is a positive correlation between the level of the TBA in the umbilical vein and the damage of the placenta in ICP. Conclusion: The TBAs were significantly higher in umbilical vein and were related to the placental damage in ICP.展开更多
目的:探讨妊娠期肝内胆汁淤积症(ICP)与妊娠期糖尿病(GDM)的相关性。方法:选取2013年2月至2021年2月在北京大学深圳医院产科分娩的GDM孕妇5517例(GDM组)和非GDM孕妇5517例(非GDM组),采用单因素、多因素和分层分析法分析ICP与GDM、ICP与...目的:探讨妊娠期肝内胆汁淤积症(ICP)与妊娠期糖尿病(GDM)的相关性。方法:选取2013年2月至2021年2月在北京大学深圳医院产科分娩的GDM孕妇5517例(GDM组)和非GDM孕妇5517例(非GDM组),采用单因素、多因素和分层分析法分析ICP与GDM、ICP与血糖水平、总胆汁酸与GDM的相关性。结果:GDM组中ICP比例显著大于非GDM组,差异有统计学意义(P<0.05)。GDM合并ICP患者的OGTT-1h血糖显著高于GDM未合并ICP患者(P<0.05),两组患者OGTT-0h或2h血糖比较,差异无统计学意义(P>0.05)。与非GDM组比较,GDM组中重度ICP占ICP总体的比例显著增高(34.88%vs 9.68%,P<0.001);ICP病例中,与未合并GDM患者比较,合并GDM的患者血清总胆汁酸显著升高(中位数29.10μmol/L vs 20.65μmol/L,P<0.01)。多因素分析提示,ICP与GDM显著相关(OR=1.426,95%CI为1.011~2.011,P=0.043),这与非高龄妊娠、单胎妊娠、经产妇中的分层分析结果一致。结论:ICP与GDM存在显著相关性,并且这种相关性在重度ICP中更明显,ICP可能是GDM的风险因素之一。展开更多
目的探讨血清甘胆酸(glycocholic acid,CG)、总胆汁酸(total bile acid,TBA)等生化指标联合天冬氨酸转氨酶(AST)/血小板(PLT)比率指数(APRI)对肝脏疾病的诊断价值。方法选取90例肝病患者,按临床诊断分成病毒性肝炎(36例)、肝硬化(36例)...目的探讨血清甘胆酸(glycocholic acid,CG)、总胆汁酸(total bile acid,TBA)等生化指标联合天冬氨酸转氨酶(AST)/血小板(PLT)比率指数(APRI)对肝脏疾病的诊断价值。方法选取90例肝病患者,按临床诊断分成病毒性肝炎(36例)、肝硬化(36例)和肝癌(18例)3个亚组,另选取同期进行健康体检人员45例作为健康对照组。测定CG、TBA等各项生化指标并通过公式计算相应指数,经统计学分析单个生化指标以及将各生化指标进行不同组合后,分别分析其与肝脏疾病的相关性,探究其在诊断肝脏疾病中的应用价值。结果除病毒性肝炎组的FIB-4外,肝病组中其余指标均显著高于健康对照组(P<0.05)。除血清ALT指标外,肝硬化和肝癌组各指标均高于病毒性肝炎组(P<0.05);受试者工作曲线分析显示,TBA曲线下面积最大,且灵敏性最高;CG的特异性最高;APRI相关指标数据优于丙氨酸氨基转移酶(ALT)等传统肝功能指标;联合CG、TBA、APRI 3个指标进行肝脏疾病诊断时,其阳性检出率最高。结论在肝脏疾病的诊断中,血清TBA和CG的诊断效能较高,并且与APRI 3者联合应用在提示肝脏不同疾病时具有一定的临床价值。展开更多
为探究诺尼果多糖对长期高脂膳食引起的代谢紊乱和肥胖的预防作用及其可能机制,该研究分别通过饲以高脂饲料建立高脂膳食小鼠模型和灌胃广谱抗生素建立伪无菌小鼠模型,分析比较诺尼果多糖干预对高脂膳食小鼠体质量、粪便总胆汁酸含量(To...为探究诺尼果多糖对长期高脂膳食引起的代谢紊乱和肥胖的预防作用及其可能机制,该研究分别通过饲以高脂饲料建立高脂膳食小鼠模型和灌胃广谱抗生素建立伪无菌小鼠模型,分析比较诺尼果多糖干预对高脂膳食小鼠体质量、粪便总胆汁酸含量(Total Bile Acid,TBA)和肠道菌群组成的影响。结果表明与高脂膳食组相比,诺尼果多糖组小鼠体质量降低11.91%,粪便总胆汁酸含量增加29.58%。但在伪无菌高脂膳食小鼠中,诺尼果多糖的上述作用未能有效发挥,说明肠道菌群在诺尼果多糖抑制高脂膳食小鼠体质量增长,促进小鼠粪便总胆汁酸排出中发挥关键作用。Spearman相关性分析结果表明,粪杆菌(Faecalibaculum)、杜氏乳杆菌(Dubosiella)、鼠杆菌(Muribaculaceae)等是在第4周和第12周均发挥促进TBA排出,抑制小鼠体质量增长作用的菌属。该研究结果表明,诺尼果多糖通过促进上述有益肠道菌的增殖,发挥促进高脂膳食小鼠TBA排出,抑制高脂膳食小鼠体质量增长的作用。展开更多
目的:观察扶正固本汤对胆总管结石术后患者肝功能及胆汁生化指标的影响。方法:选取2019年9月至2023年9月行胆总管探查取石术的患者134例,按照随机数字表法分为对照组和观察组,每组各67例。对照组术后给予常规治疗,观察组则给予扶正固本...目的:观察扶正固本汤对胆总管结石术后患者肝功能及胆汁生化指标的影响。方法:选取2019年9月至2023年9月行胆总管探查取石术的患者134例,按照随机数字表法分为对照组和观察组,每组各67例。对照组术后给予常规治疗,观察组则给予扶正固本汤治疗。比较两组患者的临床疗效、不良反应发生率及治疗前后中医证候积分、肝功能指标[谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartateaminotransferase,AST)、γ-谷氨酰转肽酶(γ-GT)]、胆汁生化指标[总胆红素(total bilirubin,TBIL)、总胆汁酸(total bile acid,TBA)]。结果:两组患者发热、腹痛、黄疸等中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。观察组有效率高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后AST、ALT以及γ-GT低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后TBA高于本组治疗前,TBIL低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:扶正固本汤运用于胆总管结石手术后,能明显提高临床疗效,改善患者肝功能及胆汁生化指标,降低不良反应。展开更多
目的分析一种商品果糖胺试剂携带污染对血清总胆汁酸测定产生的干扰,探讨消除其干扰的可行方法。方法分析总胆汁酸(Total bile acid,TBA)假性升高的原因,用健康体检人群混合血清作为样本,模拟临床常规检测果糖胺(Fructosaminen,FMN)和TB...目的分析一种商品果糖胺试剂携带污染对血清总胆汁酸测定产生的干扰,探讨消除其干扰的可行方法。方法分析总胆汁酸(Total bile acid,TBA)假性升高的原因,用健康体检人群混合血清作为样本,模拟临床常规检测果糖胺(Fructosaminen,FMN)和TBA在Beckman AU5800生化分析仪的工作程序,观察FMN试剂对TBA结果的影响。通过改变FMN试剂的加样模块或增加水清洗观察是否可以消除FMN对TBA检测的携带污染。结果检出FMN R1试剂中含有胆汁酸盐浓度为(614.2±3.1)μmol/L(x±s),R2未测出。某随机样本TBA浓度为(12.02±0.8)μmol/L,四次水洗后的浓度为(11.81±0.41)μmol/L,改变样模块后浓度为(12.09±0.59)μmol/L。结论该商品FMN R1试剂中有高浓度胆汁酸盐存在。检测时改变FMN的加样模块或增加四次水清洗可以避免FMN对TBA检测结果的干扰。展开更多
基金Natural Science Foundation of Hainan Province (No.819MS122)Hainan Provincial Department of Education Fund Project (No.hnky2017-38)。
文摘Objective:Explore the diagnostic value of total bile acids/platelets in HBV related liver fibrosis.Methods:160 patients with chronic HBV infection admitted to the Infection Department of the First Affiliated Hospital of Hainan Medical College from February 2021 to December 2022 were selected.They were divided into two groups based on the degree of liver fibrosis detected by liver biopsy:significant liver fibrosis group and non-significant liver fibrosis group.The total bile acid/blood platelet levels and their correlation with liver fibrosis in the two groups were compared and observed,and the efficacy of other non-invasive liver fibrosis diagnostic models was evaluated.Results:(1)Compared with the non-significant liver fibrosis group,the significant liver fibrosis group showed an increase in total bile acid levels,a decrease in platelet levels,and a significant increase in total bile acid/platelet levels(P<0.05).(2)Platelets decrease with the increase of liver fibrosis degree,total bile acids increase with the increase of liver fibrosis degree,and total bile acids/platelets increase with the increase of liver fibrosis degree.(3)The area under the curve(AUC)of total bile acid/platelet,APRI,FIB-4,and elastography in diagnosing the degree of liver fibrosis were 0.69,0.57,0.56,and 0.68,respectively.Conclusions:The diagnostic efficacy of total bile acids/platelets in diagnosing HBV related liver fibrosis is no less than that of other liver fibrosis diagnostic methods,and it is non-invasive,simple,and convenient,which is worthy of further clinical promotion and validation.
文摘Aims: The abnormal increase of bile acid is found in intrahepatic cholestasis of pregnancy (ICP). It also can be observed the damage of placental tissue in ICP. The aim of this study was to find the associations of the bile acid in umbilical vein and the damage of placental tissue. Methods: Thirty women diagnosed with ICP and fifty normal pregnant women between September 2015 and September 2017 at Nanshan District Maternity & Child Healthcare Hospital of Shenzhen were included in this study. The glycocholic acid (GA), total bile acids (TBA), total bilirubin (TB), direct bilirubin (DB) and albumin level in umbilical vein were measured by cycle enzyme method in ICP and control group. The placental damage was analyzed by morphologic study using hematoxylin dyes in two groups. The correlation between the level of the bile acid in the umbilical vein and the damage of the placenta was assessed using SPSS software. Results: The GA, TBA, TB, DB and albumin level in umbilical vein were significantly higher in ICP than those of pregnant women, respectively. The placental villis were expanded and the structure was destroyed in ICP. The vessel was damaged and the cell trophoblast hyperplasia in ICP. It also can be seen that there was obvious nodules and a typical fibrous necrotic substance in ICP but not in control group. There is a positive correlation between the level of the TBA in the umbilical vein and the damage of the placenta in ICP. Conclusion: The TBAs were significantly higher in umbilical vein and were related to the placental damage in ICP.
文摘目的:探讨妊娠期肝内胆汁淤积症(ICP)与妊娠期糖尿病(GDM)的相关性。方法:选取2013年2月至2021年2月在北京大学深圳医院产科分娩的GDM孕妇5517例(GDM组)和非GDM孕妇5517例(非GDM组),采用单因素、多因素和分层分析法分析ICP与GDM、ICP与血糖水平、总胆汁酸与GDM的相关性。结果:GDM组中ICP比例显著大于非GDM组,差异有统计学意义(P<0.05)。GDM合并ICP患者的OGTT-1h血糖显著高于GDM未合并ICP患者(P<0.05),两组患者OGTT-0h或2h血糖比较,差异无统计学意义(P>0.05)。与非GDM组比较,GDM组中重度ICP占ICP总体的比例显著增高(34.88%vs 9.68%,P<0.001);ICP病例中,与未合并GDM患者比较,合并GDM的患者血清总胆汁酸显著升高(中位数29.10μmol/L vs 20.65μmol/L,P<0.01)。多因素分析提示,ICP与GDM显著相关(OR=1.426,95%CI为1.011~2.011,P=0.043),这与非高龄妊娠、单胎妊娠、经产妇中的分层分析结果一致。结论:ICP与GDM存在显著相关性,并且这种相关性在重度ICP中更明显,ICP可能是GDM的风险因素之一。
文摘为探究诺尼果多糖对长期高脂膳食引起的代谢紊乱和肥胖的预防作用及其可能机制,该研究分别通过饲以高脂饲料建立高脂膳食小鼠模型和灌胃广谱抗生素建立伪无菌小鼠模型,分析比较诺尼果多糖干预对高脂膳食小鼠体质量、粪便总胆汁酸含量(Total Bile Acid,TBA)和肠道菌群组成的影响。结果表明与高脂膳食组相比,诺尼果多糖组小鼠体质量降低11.91%,粪便总胆汁酸含量增加29.58%。但在伪无菌高脂膳食小鼠中,诺尼果多糖的上述作用未能有效发挥,说明肠道菌群在诺尼果多糖抑制高脂膳食小鼠体质量增长,促进小鼠粪便总胆汁酸排出中发挥关键作用。Spearman相关性分析结果表明,粪杆菌(Faecalibaculum)、杜氏乳杆菌(Dubosiella)、鼠杆菌(Muribaculaceae)等是在第4周和第12周均发挥促进TBA排出,抑制小鼠体质量增长作用的菌属。该研究结果表明,诺尼果多糖通过促进上述有益肠道菌的增殖,发挥促进高脂膳食小鼠TBA排出,抑制高脂膳食小鼠体质量增长的作用。
文摘目的:观察扶正固本汤对胆总管结石术后患者肝功能及胆汁生化指标的影响。方法:选取2019年9月至2023年9月行胆总管探查取石术的患者134例,按照随机数字表法分为对照组和观察组,每组各67例。对照组术后给予常规治疗,观察组则给予扶正固本汤治疗。比较两组患者的临床疗效、不良反应发生率及治疗前后中医证候积分、肝功能指标[谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartateaminotransferase,AST)、γ-谷氨酰转肽酶(γ-GT)]、胆汁生化指标[总胆红素(total bilirubin,TBIL)、总胆汁酸(total bile acid,TBA)]。结果:两组患者发热、腹痛、黄疸等中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。观察组有效率高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后AST、ALT以及γ-GT低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后TBA高于本组治疗前,TBIL低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:扶正固本汤运用于胆总管结石手术后,能明显提高临床疗效,改善患者肝功能及胆汁生化指标,降低不良反应。
