终末期肾脏病血液透析患者血清胆汁酸谱检测与分析

李蓉; 曾粒; 钟玲

doi:10.16016/j.1000-5404.201903129

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终末期肾脏病血液透析患者血清胆汁酸谱检测与分析

临床医学 | 更新时间：2026-01-09

- 终末期肾脏病血液透析患者血清胆汁酸谱检测与分析
- Detection and analysis of serum bile acid profile in patients with end-stage renal disease undergoing hemodialysis
- 第三军医大学学报 2019年41卷第16期页码：1583-1589
- 作者机构：
  
  400010 重庆，重庆医科大学附属第二医院肾内科
- 作者简介：
  
  [ 钟玲，E-mail: zhongling@hospital.cqmu.edu.cn ZHONG Ling, E-mail: zhongling@hospital.cqmu.edu.cn
- 基金信息：
  
  中国博士后科研基金(2018M633630XB);重庆市教委科技攻关项目(KJQN201800403)
- DOI：10.16016/j.1000-5404.201903129
  中图分类号： R446.11; R459.5; R692
- 收稿：2019-03-15，
  
  修回：2019-04-10，
  
  纸质出版：2019-08-30
- 稿件说明：
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李蓉, 曾粒, 钟玲. 终末期肾脏病血液透析患者血清胆汁酸谱检测与分析[J]. 第三军医大学学报, 2019,41(16):1583-1589.

Rong LI, Li ZENG, Ling ZHONG. Detection and analysis of serum bile acid profile in patients with end-stage renal disease undergoing hemodialysis[J]. Journal of Third Military Medical University, 2019, 41(16): 1583-1589.
李蓉, 曾粒, 钟玲. 终末期肾脏病血液透析患者血清胆汁酸谱检测与分析[J]. 第三军医大学学报, 2019,41(16):1583-1589. DOI： 10.16016/j.1000-5404.201903129.

Rong LI, Li ZENG, Ling ZHONG. Detection and analysis of serum bile acid profile in patients with end-stage renal disease undergoing hemodialysis[J]. Journal of Third Military Medical University, 2019, 41(16): 1583-1589. DOI： 10.16016/j.1000-5404.201903129.

摘要

目的

通过对维持性血液透析患者血清胆汁酸谱的靶向定量检测，探讨终末期肾病(end-stage renal disease，ESRD)胆汁酸谱的变化与代谢并发症及预后的关系。

方法

收集2013年12月至2016年12月重庆医科大学附属第二医院77例维持性血液透析患者(ESRD组)及本院体检中心30名健康对照(HC组)的血液标本，采用超高效液相色谱-串联质谱方法对其进行血清胆汁酸的靶向定量检测。结合单变量与多变量统计分析对终末期肾病患者与健康对照进行胆汁酸谱的差异分析。

结果

检测出6种胆汁酸在组间差异具有统计学意义，其中ESRD组鹅脱氧胆酸、脱氧胆酸、胆酸水平明显降低，甘氨鹅脱氧胆酸、牛磺鹅脱氧胆酸、甘氨胆酸水平明显升高(

0.05)。亚组分析提示牛磺胆酸、牛磺鹅脱氧胆酸、牛磺猪胆酸、牛磺α鼠胆酸水平在健康对照、终末期肾脏病存活组及死亡组呈逐渐升高趋势，差异具有统计学意义(

0.01)。

结论

终末期肾脏病胆汁酸代谢紊乱与脂代谢异常及不良预后有关。

Abstract

Objective

To explore the association of serum bile acid profile with metabolic complications and outcomes in patients with end-stage renal disease (ESRD) on maintenance hemodialysis.

Methods

Between December

2013 and December

2016

77 patients with ESRD on maintenance hemodialysis and 30 healthy subjects were recruited from the Second Affiliated Hospital of Chongqing Medical University. Fasting blood samples were collected from all the subjects

and a targeted metabolomics approach based on ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to determine the changes in serum bile acids between the ESRD patients and the healthy subjects. Univariate and multivariate analyses were performed to screen the differential bile acids between the two groups.

Results

Six differential bile acids were identified as probable biomarkers for differentiation between ESRD patients and healthy subjects. The levels of chenodeoxycholic acid

deoxycholic acid

and cholic acid were significantly decreased

and the levels of glycochenodeoxycholic acid

taurochenodeoxycholic acid

and

glycocholic acid were significantly increased in ESRD patients(

0.05). Subgroup analyses suggested that the levels of taurocholic acid

taurochenodeoxycholic acid

taurohyocholic acid

and tauro α-muricholic acid all increased significantly and progressively in the order of the healthy control group

ESRD survival group

and ESRD death group(

0.01).

Conclusion

The serum bile acid profile of ESRD patients is significantly different from that of healthy subjects

suggesting the association of bile acid metabloism disorder with the occurrence of dyslipidemia and a poor prognosis of ESRD.

关键词

Keywords

references

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