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中华重症医学电子杂志 ›› 2019, Vol. 05 ›› Issue (02) : 127 -131. doi: 10.3877/cma.j.issn.2096-1537.2019.02.009

所属专题: 文献

临床研究

代谢组学方法分析重症谵妄患者的血清代谢物
袁荆1, 鲁卫华1,(), 陈群1, 曹迎亚1, 王箴1, 姜小敢1, 吴敬医1   
  1. 1. 241001 安徽芜湖,皖南医学院弋矶山医院重症医学科
  • 收稿日期:2019-02-01 出版日期:2019-05-28
  • 通信作者: 鲁卫华
  • 基金资助:
    安徽省科技计划项目(1604f0804043); 安徽省高校学科(专业)拔尖人才学术资助项目(gxbjZD19); 安徽省学术和技术带头人后备人选科研资助项目(2017H145)

Magnetic resonance spectroscopy-based plasma metabolomics study of delirium in critically ill patients

Jing Yuan1, Weihua Lu1,(), Qun Chen1, Yingya Cao1, Zhen Wang1, Xiaogan Jiang1, Jingyi Wu1   

  1. 1. Department of Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu 241001, China
  • Received:2019-02-01 Published:2019-05-28
  • Corresponding author: Weihua Lu
  • About author:
    Corresponding author: Lu Weihua, Email:
引用本文:

袁荆, 鲁卫华, 陈群, 曹迎亚, 王箴, 姜小敢, 吴敬医. 代谢组学方法分析重症谵妄患者的血清代谢物[J]. 中华重症医学电子杂志, 2019, 05(02): 127-131.

Jing Yuan, Weihua Lu, Qun Chen, Yingya Cao, Zhen Wang, Xiaogan Jiang, Jingyi Wu. Magnetic resonance spectroscopy-based plasma metabolomics study of delirium in critically ill patients[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(02): 127-131.

目的

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。

方法

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。

结果

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。

结论

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。

Objective

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

Methods

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.

Results

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.

Conclusions

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.

表1 2组患者一般资料比较
图1 各组代表性样品的1H 600 MHz核磁共振图谱
图2 谵妄组与非谵妄组患者主成分分析
图3 谵妄组与非谵妄组患者偏最小二乘法-判别分析得分图(a)与排列试验验证结果(b)。图a中方块为谵妄组,实心圆为非谵妄组;图b中三角形为R2,方块为Q2
图4 谵妄组与非谵妄组的正交偏最小二乘法-判别分析得分图(a)与相关系数负载图(b)。图a中方块为谵妄组,实心圆为非谵妄组;图b中Acet为乙酰乙酸;Citr为柠檬酸;Ala为丙氨酸;Val为缬氨酸;Ile为异亮氨酸;Leu为亮氨酸
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