血清胆汁酸谱在婴儿巨细胞病毒肝炎中的变化及其临床意义

Objective To investigate the changes in serum bile acid profile of cytomegalovirus (CMV) hepatitis in infants, and to analyze its clinical significance. Methods 72 infants from 1 to 3 months with CMV hepatitis admitted to Zhiji People''s Hospital from January 2019 to August 2021 were selected as the observation group. According to different types of hepatitis, the infants were divided into the following four subgroups: jaundice hepatitis group (n = 24), cholestasis hepatitis group (n = 18), non-jaundice hepatitis group (n = 16), and subclinical hepatitis group (n = 14). 60 infants with healthy physical examination during the same period were selected as the control group. Detect the serum bile acid profile levels of the two groups [cholic acid (CA), chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), lithocholic acid (LCA), deoxycholic acid (DCA), glycocholic acid (GCA), glycocholic acid (GLCA), glycoursodeoxycholic acid (GUDCA), glycochenodeoxycholic acid (GCDCA), glycodeoxycholic acid (GDCA), taurocholic acid (TLCA), tauroursodeoxycholic acid (TUDCA), tauroche二nodeoxycholic acid (TCDCA), taurodeoxycholic acid (TDCA), taurocholic acid (TCA) ]. The bile acid profile levels of the observation group were detected in the pre treatment, at the end of the induction period, at the end of the maintenance period, and 1 month after the course of treatment. Results ① The levels of serum CA, GCA, GUDCA, GCDCA, TUDCA, TCDCA and TCA in the observation group were higher than those in the control group, and the levels of serum UDCA, LCA, DCA, and GLCA were lower than those in the control group (P ＜ 0.05). ② The levels of serum UDCA, GUDCA and GCDCA in the subclinical hepatitis group were higher than those in the jaundice hepatitis group, and CDCA, UDCA, LCA, DCA and GDCA were higher than those in the cholestasis hepatitis group, and CDCA, UDCA, GUDCA and GCDCA were higher than those in the non-jaundice hepatitis group (P ＜ 0.05). ③ The levels of serum CA, UDCA, GCA, DCA, GUDCA, GCDCA, TUDCA, TCDCA, TDCA, TCA at 1 month after the course of treatment were lower than those in the pre treatment and at the end of the induction period and the maintenance period. Conclusion Infants with CMV hepatitis have bile acid metabolism disorders, and serum bile acid spectrum among different types and different disease stages of CMV hepatitis have some differences. The results provide theoretical basis for further study of metbaolic mechanisms.