婴儿巨细胞病毒肝炎不同中医证型的尿液代谢组学研究  

Urinary Metabolomics Study on Infantile Human Cytomegalovirus Hepatitis of Different Chinese Medicine Syndromes

作　　者：李维薇 贺丽丽[3] 单进军 谢彤[2] 杜丽娜[4] 杨燕[4] 汪受传[1] LI Wei-wei;HE Li-li;SHAN Jin-jun;XIE Tong;DU Li-na;YANG Yan;WANG Shou-chuan(Department of Pediatric,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing(210023 );Institute of Pediatrics,Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing(210023 );Department of Pediatric,Jiangsu Province Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing (210028);Department of Traditional Chinese Medicine,Beijing Children's Hospital Affiliated to Capita/Medical University,Beijing (100045))

机构地区：[1]南京中医药大学附属医院儿科,南京210023 [2]南京中医药大学中医儿科学研究所,南京210023 [3]江苏省中西医结合医院儿科,南京210023 [4]首都医科大学附属北京儿童医院中医科,北京100045

出　　处：《中国中西医结合杂志》2019年第2期162-168,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81473725);江苏省研究生科研与实践创新计划项目(No.KYCX18_1550)

摘　　要：目的探讨婴儿巨细胞病毒肝炎不同证型的尿液代谢组学特征。方法筛选84例婴儿巨细胞病毒肝炎患儿分为湿热内蕴证(39例)、脾虚湿困证(28例)、气滞血瘀证(17例),另选健康对照组39名。采用气相色谱及质谱联用(GC-MS)技术对尿液样本进行代谢组学检测,经主成分分析寻找各证型的差异性代谢物。结果生化指标分析显示:湿热内蕴证与脾虚湿困证的总胆红素、结合胆红素及碱性磷酸酶水平存在差异(P <0. 05);湿热内蕴证与气滞血瘀证的天门冬氨酸氨基转移酶、总胆红素、结合胆红素、总胆汁酸水平及凝血酶原时间存在差异(P <0. 05);脾虚湿困证与气滞血瘀证的天门冬氨酸氨基转移酶、总胆红素、结合胆红素、总胆汁酸、碱性磷酸酶水平及凝血酶原时间存在差异(P <0. 05)。代谢组学研究显示:各证型在OPLS-DA图上区分明显,各证型间差异性代谢物涉及多种氨基酸代谢、能量代谢及肠道菌群相关代谢物紊乱。结论婴儿巨细胞病毒肝炎湿热内蕴证、脾虚湿困证及气滞血瘀证存在各自的尿液代谢组学特征。Objective To investigate the urinary metabolomic characteristics of different Chinese medicine( CM)syndromes in infantile human cytomegalovirus hepatitis. Methods Totally 84 infantile human cytomegalovirus hepatitis patients were screened and assigned to damp-heat syndrome( 39 cases),Pi-deficiency with dampness encumbrance syndrome( 28 cases),Qi stagnation and blood stasis syndrome( 17 cases). Another 39 cases of normal control were collected at the same time. A non-targeted gas chromatography-mass spectrometry( GC-MS) metabolomics method was used in conjunction with orthogonal partial least squares discriminant analysis( OPLS-DA) to explore the differential metabolites and pathways of the three CM syndromes. Results In clinical index analysis,damp-heat syndrome and Pi-deficiency with dampness encumbrance syndrome differ in total bilirubin( TBIL),direct bilirubin( DBIL) and alkaline phosphatase( ALP,P < 0. 05).Damp-heat syndrome and Qi stagnation and blood stasis syndrome differ in aspartate aminotransferase( AST),TBIL,DBIL,total bile acid( TBA) and prothrombin time( PT,P < 0. 05). Pi-deficiency with dampness encumbrance syndrome and Qi stagnation and blood stasis syndrome differ in AST,TBIL,DBIL,TBA,ALP and PT(P < 0. 05). In metabolomic study,the OPLS-DA score plots revealed clear differentiation among the three CM syndromes. The differential metabolites between the three CM syndromes involve a variety of amino acid metabolism,energy metabolism and intestinal bacterial metabolism disorders. Conclusion Three CM syndromes of infantile human cytomegalovirus hepatitis have specific urinary metabolomic profiles,which indicated that different CM syndromes have their specific biological basis.

关 键 词：婴儿巨细胞病毒肝炎 中医证候 代谢组学 湿热内蕴证 脾虚湿困证 气滞血瘀证 

分 类 号：R272[医药卫生—中医儿科学]