Clinic Study About Bile Acids In Patients With Biliary Tract Diseases By Coupling Of Ultra-fast Liquid Chromatography With Mass Spectrum

Gallstone disease is stones in the biliary tract then cause a series of symptoms. The stones are oversaturated and aggregated by some compo- sitions of bile (bilirubin, cholesterol, mucin, calcium and so on). Lots of factors participate in this course. The two types of gallstones are cholesterol stones and pigment stones. More than 90 percent of gallstones consist mainly of cholesterol. Stones are formed at any place of the biliary tract. According to a statistical analysis, 70 percent gallbladder stones are cholesterol and 70 percent of primary bile duct stones are mainly pigment stones. The stones which come from gallbladder but stay at common bile duct are cholesterol stones. The differences of two types stones display the pathogenesises are not similar.Most of the results focus on the serum bile acids. They demonstrate that the content of the seven conjugated bile acids of the gallstone persons are much more than the normal persons'. These indicate that the components of bile acids are changed. The ratio of chenodeoxycholic acid (CDCA) is decrease. But other researches have opposite results. Furthermore, some experiments demonstrate that the taurolithocholic acid (TLCA) of serum bile acids is markedly higher in common bile duct stones'but lower in gallbladder stones'.Objective: To find the differences of three diseases (chronic cholecy- stitis with polypi, chronic cholecystitis with stones, common bile duct stones with/without biliary tract infection). Then shed light on the formation, components, diagnosis, treatment and prevention of the biliary tract stones. Method: 3 patients have chronic cholecystitis with polypi. 3 patients have chronic cholecystitis with stones. 9 patients have common bile duct stones with/without biliary tract infection. Those bile acids were measured by coupling of ultra-fast liquid chromatography with mass spectrum (HPLC- MS).Result: There are eight conjugated bile acids in three different biliary tract diseases. They are taurocholic acid (TCA), glycocholic acid (GCA), taurochenodeoxycholic acid (TCDCA), glycoursodeoxycholic acid (GUDCA), taurodeoxycholic acid (TDCA), glycodeoxycholic acid (GDCA), taurolithocholic acid (TLCA) and glycolithocholic acid (GLCA). All of specimens have TCA, GCA and TDCA. But GUDCA is only common bile duct stones specimens have and TLCA, GLCA are only gallbladder polypi and gallstones specimens have.Conclusion: Gallbladder polypi and cholesterol stones have some pathogenesises in common. Gallbladder polypi and gallbladder stones have lots of differences with common bile duct stones in conjugated bile acids. UFLC-MS is the advanced and useful technique for bile acids research.