肝脏 ›› 2022, Vol. 27 ›› Issue (10): 1112-1115.

• 药物性肝损伤 • 上一篇    下一篇

检测吡咯里西啶生物碱辅助诊断肝窦阻塞综合征

邵幼林, 熊爱珍, 张锁才, 吴剑明, 马春明, 郭风彩, 柳龙根   

  1. 213001 江苏 常州市第三人民医院肝病科(邵幼林,张锁才,吴剑明,马春明,郭风彩,柳龙根);上海中医药大学中药研究所中药标准化教育部重点实验室暨国家中医药管理局中药新资源与质量评价重点实验室(熊爱珍)
  • 收稿日期:2022-05-27 出版日期:2022-10-31 发布日期:2022-11-22
  • 通讯作者: 柳龙根,Email:ssewllg@163.com;熊爱珍,Email:a.z.xiong@hotmail.com
  • 基金资助:
    常州市应用基础研究计划项目(CJ20190080);上海市人才发展资金(2020099)

Hepatotoxic pyrrolizidine alkaloid detection accurately diagnosed HPA-HSOS

SHAO You-lin1, XIONG Ai-zhen2, ZHANG Suo-cai1, WU Jian-ming1, MA Chun-ming1, GUO Feng-cai1, LIU Long-gen1   

  1. 1. Department of Hepatology, Changzhou Third People's Hospital, Changzhou 213001, China;
    2. The Ministry of Education Key Laboratory for Standardization of Chinese Medicines and the State Administration of Traditional Chinese Medicine Key Laboratory for New Resources and Quality Evaluation of Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai 201203, China
  • Received:2022-05-27 Online:2022-10-31 Published:2022-11-22
  • Contact: LIU Long-gen, Email:ssewllg@163.com; XIONG Ai-zhen, Email:a.z.xiong@hotmail.com

摘要: 目的 探讨检测摄入物中吡咯里西啶生物碱(HPA)成分辅助诊断肝窦阻塞综合征(HPA-HSOS)的可行性。方法 收集1例服用菊三七叶和 4例服用三七粉或三七酒患者的临床资料。Acquity Ultra Performance LCTM-Micromass ZQ 2000液质联用仪检测患者服用物中千里光菲灵碱、千里光碱、菊三七碱甲及其N-氧化物等6种主要肝毒性HPA的含量。结果 4例患者诊断HPA-HSOS,1例患者排除HPA-HSOS。菊三七根、茎、叶中均含有HPA,HPA含量为根>叶>茎。结论 通过检测患者服用物中肝毒性HPA可诊断HPA-HSOS。

关键词: 菊三七, 肝窦阻塞综合征, 吡咯里西啶生物碱

Abstract: Objective To investigate the feasibility of detecting hepatotoxic pyrrolizidine alkaloids (HPA) in patients’ ingestion in the diagnosis of HPA-hepatic sinusoidal obstruction syndrome (HSOS). Methods Clinical datas were collected from 1 patient taking Gynura Segetum Lour and 4 patients taking “Sanqi powder” or “Sanqi wine”. Acquity Ultra Performance LCTM-Micromass ZQ 2000(UPLC-MS) was used to determine the levels of six major hepatotoxic pyrrolizidine alkaloids, including seneciphylline, seneciphylline N-oxide, senecionine, senecionine N-oxide, seneciphyllinine and seneciphyllinine N-oxide. Results ① 4 patients were diagnosed with HPA-HSOS, and 1 patient was excluded from HPA-HSOS. ② HPA was found in roots, stems and leaves of Gynura Segetum, and the content of HPA was root > leaf > stem. Conclusion HPA-HSOS can be accurately diagnosed by detecting HPA in patients’ ingestion.

Key words: Gynura segetum, Hepatic sinusoidal obstruction syndrome, Hepatotoxic pyrrolizidine alkaloid, Accurate diagnosis