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摘要：
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摘要：目的 分析非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）患者粪便中聚酮合
酶（polyketide synthase，PKS）基因簇（即PKS岛）分布及外周血内生性乙醇水平。方法 以2018年
4月至2018年9月于首都医科大学附属北京地坛医院门诊及住院部就诊的32例NAFLD患者为NAFLD
组，选取同期37例本院健康体检志愿者为对照组，留取受试者粪便标本及血液标本，提取粪便标本
的全基因组模板，采用PCR法检测PKS岛的分布，采用Biovison试剂盒对血液标本中乙醇浓度进行检
测。采用HITACHI 7600型自动生化分析仪检测丙氨酸氨基转移酶（alanine transaminase，ALT）、天
门冬氨酸氨基转移酶（aspartate transaminase，AST）、总胆红素（total bilirubin，TBil）、总胆固醇
（total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白胆固醇（high-density lipoprotein
cholesterol，HDL-C）及低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）等生物化学
指标。结果 NAFLD组ALT为 [28.55（17.33，39.55）] U/L，高于健康对照组的 [12.80（9.60，22.75）] U/L，
差异有统计学意义（z =-4.073，P ＜ 0.01）；NAFLD组TG为（2.35 ± 2.40）mmol/L，高于健康对照组
的（0.92 ± 0.70）mmol/L，差异有统计学意义（t =-3.466，P = 0.001）；AST、TBil、TC、HDL-C及
LDL-C差异无统计学意义（均P ＞ 0.05）。NAFLD组粪便标本PKS岛阳性率为6.25%（2/32），健康对
照组为24.32%（9/37），差异有统计学意义（χ 2 = 4.183，P = 0.041）。NAFLD组中3例患者外周血中
检出乙醇，浓度分别为13.24 mg/L、1.32 mg/L、0.06 mg/L；健康对照组外周血中均未检出乙醇。结论
NAFLD患者粪便中PKS岛阳性率低于健康对照组；部分NAFLD患者外周血中有内生性乙醇的存在。
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Abstract: Objective To analyze the distribution of polyketide synthase (PKS) islands in feces and
endogenous ethanol in peripheral blood of patients with non-alcoholic fatty liver disease (NAFLD). Methods
Total of 32 patients with NAFLD in the outpatient and inpatient department of Beijing Ditan Hospital, Capital
Medical University from April 2018 to September 2018 were enrolled as NAFLD group, and 37 volunteers
of physical examination in our hospital were enrolled as control group. The feces samples and blood
samples were collected. The whole genome template of fecal specimens were extracted and the distribution
of PKS island were detected by PCR. The alcohol content in blood samples were detected by Biovison kit.
The biochemistry indicators [alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBil),
total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein
cholesterol (LDL-C)] were detected by HITACHI 7600 fully automatic biochemistry analyser. Results ALT level
of patients in NAFLD group was [28.55 (17.33, 39.55)] U/L, which was significantly higher than that in control
group [12.80 (9.60, 22.75)] U/L, the difference was statistically significant (z = -4.073, P ＜ 0.01). The TG level
of patients in NAFLD group was (2.35 ± 2.40) mmol/L, which was higher than that in control group [(0.92 ±
0.70) mmol/L], the difference was statistically significant (t = -3.466, P = 0.001). No significant differences
were found in the levels of AST, TBil, TC, HDL-C and LDL-C between the two groups (all P ＞ 0.05). The
positive rate of PKS in feces of patients in NAFLD group was 6.25% (2/32), which was 24.32% (9/37) in
healthy control group, the difference was statistically significant (χ 2 = 4.183, P = 0.041). In NAFLD group,
there were three cases whose ethanol were positive in peripheral blood, the concentration were 13.24 mg/L,
1.32 mg/L and 0.06 mg/L, respectively. No ethanol was detected in peripheral blood of healthy control group.
Conclusion The positive rate of PKS islands in feces of patients with NAFLD was lower than that of healthy
controls and presence of endogenous ethanol in peripheral blood of patients with NAFLD was confirmed.
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