基于磁共振代谢组学方法分析发生谵妄的重症患者血清代谢物标志物。

选择2016年2月至2017年9月皖南医学院弋矶山医院重症医学科（ICU）发生谵妄的患者18例（谵妄组），同时选择匹配的未发生谵妄的18例患者作为对照（非谵妄组）。采用磁共振（¹H磁共振）方法检测2组患者血清代谢组学，主成分分析（PCA）法进行多变量数据分析，偏最小二乘法-判别分析（PLS-DA）法进行模型验证，正交偏最小二乘法-判别分析（OPLS-DA）筛选及鉴定2组患者间存在显著差异的代谢产物。

与非谵妄组患者相比，谵妄组患者的异亮氨酸、亮氨酸、缬氨酸、丙氨酸和乙酰乙酸的峰值明显增高，而柠檬酸的峰值则明显降低。

ICU患者发生谵妄时，机体氨基酸代谢、三羧酸循环和酮体代谢异常，基于磁共振的代谢组学技术有助于发现谵妄患者差异标志代谢物。

To conduct a metabonomics study of blood plasma from intensive care unit (ICU) patients with delirium based on magnetic resonance spectroscopy (NMR).

Thirty-six ICU patients were selected prospectively from February 2016 to September 2017, and divided into either a delirium group or a non-delirium group, with 18 patients in each group. NMR was performed to analyze the difference in serum metabolomics between the two groups. Principal component analysis (PCA) was used for multivariate data analysis, partial least-squares discriminant analysis (PLS-DA) was used for model validation, and orthogonal partial least-squares discriminant analysis (OPLS-DA) was used to screen and identify metabolites with significant differences between the two groups.

Metabonomics analysis indicated that plasma concentrations of valine, leucine, alanine, and acetoacetate in the delirium group were significantly increased compared with the non-delirium group, while plasma concentration of citrate significantly decreased in the delirium group compared with the non-delirium group. Those metabolites were associated with amino acid metabolism, tricarboxylic acid, and ketone body metabolism.

When delirium occurs in ICU patients, the body′s amino acid metabolism, tricarboxylic acid circulation, and ketone body metabolism are abnormal. NMR-based metabolomics technology can help identify different markers of metabolites in delirium patients.