目的：运用代谢组学方法，探讨慢性乙型病毒性肝炎（乙肝）后肝硬化患者证候间尿代谢物的差异及其代谢模式。方法：采用GC/MS的尿液衍生化方法，分析乙肝后肝硬化患者不同证候内源性小分子代谢物，并进行单维和多维统计分析，通过与标准品的对照确认差异性代谢物。结果：在健康者与乙肝后肝硬化患者、不同中医证候的患者间，均获得了差异性尿代谢物，这些代谢物与能量代谢和氨基酸代谢等通路密切相关。其中在湿热内蕴证与肝肾阴虚证之间存在支链氨基酸的差异。结论：乙肝后肝硬化患者不同证候间存在着尿代谢物的差异，证候间可能具有不同的代谢模式。

This study was aimed to analyze the differences and metabolic mode of urinary metabolites in traditional Chinese medicine (TCM) syndrome types of patients with cirrhosis caused by hepatitis B. A combined gas chromatography and mass spectrometry (GC-MS) method was developed which is suitable for the urine sample treatment in aqueous phase with ethyl chloroformate (ECF) derivatization agents. The multivariate statistical technique was used and complete differentiation was achieved between patients with cirrhosis caused by hepatitis B and normal subjects, as well as among patients with different syndrome types. According to the verification of material difference through one-dimensional statistics, energy metabolism and amino acid metabolism pathways were observed which are closely related to metabolites. It is suggested that these are differences of urinary metabolites and metabolic mode between normal subjects and patients with cirrhosis caused by hepatitis B, and among different TCM syndrome types.

科学技术部国家“十一五”支撑计划项目(2006BAI08B02-06)：系统科学视角下的肝炎肝硬化临床疗效评价方法研究，负责人：苏式兵，张永煜；“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项项目（2012ZX10005001-004）：病毒性肝炎证候生物学基础研究平台的建立，负责人：胡义扬，子课题负责人：张永煜。