5-羟色胺对重症社区获得性肺炎严重程度的预测研究  

Predictive research of 5-hydroxytryptamine in severity of severe community-acquired pneumonia

作　　者：何权 刘丹瑜 叶君 张艳丽[1] 朱华栋[2] 蒋澄宇[1] 徐军[2] HE Quan;LIU Dan-yu;YE Jun;ZHANG Yan-li;ZHU Hua-dong;JIANG Cheng-yu;XU Jun(Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences CAMS, School of Basic Medicine PUMC,Beijing 100005;Department of Emergency, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730;Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]中国医学科学院基础医学研究所,北京协和医学院基础学院,生物化学与分子生物学系,北京100005 [2]中国医学科学院,北京协和医学院,北京协和医院急诊科,北京100730 [3]北京大学第一医院呼吸和危重症医学科,北京100034

出　　处：《基础医学与临床》2020年第9期1195-1200,共6页Basic and Clinical Medicine

基　　金：国家自然科学基金委员会科学中心项目(81788101);中国医学科学院医学与健康科技创新工程(2017-I2M-1-009)。

摘　　要：目的利用非靶向代谢组学分析方法,探寻重症社区获得性肺炎(SCAP)潜在预后标志物。方法采用液相色谱质谱联用分析技术(LC-MS),对2015年1月至2019年6月收集于北京协和医院的30名健康成人志愿者和68例重症社区获得性肺炎患者的血浆样本进行代谢物检测。根据临床预后,患者可分为存活组(n=1949)和死亡组(n=1919)。采用多元统计分析方法OPLS-DA和单变量统计分析方法Kruskal Wallis检验筛选差异代谢物。对差异代谢物进行预后分析和相关性分析。结果液相色谱质谱联用分析技术检测出健康成人与重症社区获得性肺炎患者共有代谢物3463个。OPLS-DA和Kruskal Wallis Test分析方法筛选出差异代谢物126个。5-羟色胺(5-HT)在存活组和死亡组间具有显著性差异(P<0.05,AUC>0.75)。5-HT与氧合指数(OI)呈正相关,与急性生理与慢性健康评分Ⅱ(APACHEⅡ)呈负相关。结论5-HT能够预测重症社区获得性肺炎患者的预后,可作为预后预测的潜在生物标志物。Objective To search for potential prognostic markers for severe community-acquired pneumonia(SCAP) using non-targeted metabolomics. Methods Testing plasma samples from 30 healthy people and 68 SCAP patients(all collected from January 2015 to June 2019 at Peking Union Medical College Hospital) by liquid chromatography mass spectrometry(LC-MS). According to clinical prognosis, patients were divided into survive group(n=1 949) and non-survive group(n=1 919). OPLS-DA(multivariate statistical analysis) and Kruskal Wallis Test(single variable statistical analysis) were used to identify differential metabolites. Correlation analysis of clinical indicators and prognostic analysis were also used for differential metabolites. Results Totally 3 463 metabolites were detected in healthy people and SCAP patients by LC-MS. Among them, 126 metabolites were screened out by OPLS-DA andKruskal Wallis Test analysis methods. Prognostic analysis showed that the quantity of 5-hydroxytryptamine(5-HT)was significantly different between survive group and non-survive group(P<0.05, AUC>0.75). Correlation analysis of clinical indicators showed that 5-HT was positively correlated with oxygenation index(OI) and negatively correlated with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score. Conclusions The 5-HT as a potential prognostic marker for SCAP, may predict the prognosis of SCAP patients.

关 键 词：5-羟色胺(5-HT) 重症社区获得性肺炎(SCAP) 预后标志物 代谢组学 

分 类 号：R181.38[医药卫生—流行病学]