基于1H NMR技术对COPD急性加重期血清特征性代谢物的研究  

作　　者：杨秀云[1] 黄飞华[1] 吴美倩[1] 张永建[2] 王晓平[2] 杨中良 

机构地区：[1]浙江省立同德医院呼吸内科,310012 [2]浙江省立同德医院海盐分院呼吸内科,314300 [3]上海天佑医院重症医学科,200331

出　　处：《浙江临床医学》2016年第12期2170-2172,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生一般研究项目（2014KYB276）;浙江省中医药科研基金项目（2014ZA112）

摘　　要：目的采用1H核磁共振（1HNMR）代谢组学技术研究慢性阻塞性肺疾病（COPD）急性加重期血清的特征性代谢物。方法31例COPD急性加重期患者（急性加重组）入院后24h内及经过常规治疗进入稳定期（稳定组）后各采集空腹静脉血2ml，离心取血清置-80℃冰箱保存。应用高分辨率1H NMR技术检测得到两组患者血清的一维氢谱图，采用SIMCA-P＋软件对氢谱图进行分段积分后的积分值进行主成分分析（PCA）和偏最小二乘法判别分析（PLS-DA）以判别两组血清代谢物有无差异。采用正交偏最小二乘法判别分析（OPLS-DA）判断差异性代谢成分。结果PCA和PLS-DA分析提示两组血清代谢物及其积分值存在部分交叉，但仍存在一定的差异，ROC分析提示模型较为可靠。OPLS-DA分析提示。与稳定组比较，急性加重组血清3-羟基丁酸、赖氨酸、谷氨酸、谷氨酰氨和丙酮酸水平明显升高，而缬氨酸、亮氨酸、异亮氨酸、极低密度脂蛋白（VLDL）和低密度脂蛋白（LDL）水平明显下降，差异均有统计学意义（P〈0．05）。说明COPD急性加重期存在严重的能量、蛋白质及脂类代谢紊乱。结论COPD急性加重与能量、蛋白质及脂类代谢紊乱有关。由于纳入研究的样本量有限，本研究结果尚需大样本研究证实。Objective To explore the serum characteristic metabolites in acute exacerbation of chronic obstructive pulmonary disease （ COPD ） by using of 1H nuclear magnetic resonance （ 1H NMR ） based metabonomics. Methods 31 COPD in-patients with acute exacerbation were included in this study. Fasting blood samples were taken from COPD patients with acute exacerbation within 24 hours after admission （ acute exacerbation group ） and after their entrance to stable stage after routine treatment （ stable stage group ） , respectively. Serum samples were stored in -80℃ refrigerator after blood centrifugation. One-dimensional hydrogen proton spectra of serum samples from two groups were measured by using highresolution 1H NMR, and the score values of which were analyzed by principal component analysis （ PCA ） and partial least square-discriminant analysis （ PLS-DA ） by using SIMCA-P＋ software, in order to identify if there is difference in the serum metabolites between two groups. Then orthogonal partial least square-discriminant analysis （ OPLS-DA ） was used to judge the characteristic metabolite Components between two groups. Results PCA and PLS-DA showed that there were differences between serum metabolites and associated scores between two groups, despite partial crossover, receiver operating characteristic curve analysis showed that model was reliable. OPLS-DA indicated that the serum levels of 3-hydroxybutyrate, lysine, glutamate, glutamine and pyruvic acid were significantly increased （ P〈0.05 ） , whereas serum levels of leucine, isoleusine, very low-density lipoprotein （ VLDL ） and low-deusity lipoprotein （ LDL ） were significantly decreased （ P〈0.05 ） in acute exacerbation group, as compared to stable stage group. Obvious disturbance of energy, protein and lipid metabolism existed in acute exacerbation of COPD, as compare with those in stable stage group. Conclusions Acute exacerbation of COPD was associated with obvious disturbance in energy, protein and lipid metabol

关 键 词：慢性阻塞性肺疾病 急性加重 特征性代谢物 1H核磁共振 代谢组学 

分 类 号：R969.1[医药卫生—药理学]