基于“同病异证”理念的HIV/AIDS患者代谢组学初步分析  

A Preliminary Analysis of HIV/AIDS Metabolomics Based on "same disease and different syndromes"

作　　者：马秀霞[1,2] 徐立然 郭会军[1,2] 孟鹏飞 袁君[1,2] 武悦 金艳涛[1,2] MA Xiuxia;XU Liran;GUO Huijun;MENG Pengfei;YUAN Jun;WU Yue;JIN Yantao(The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine,Zhengzhou 450000;Henan University of Traditional Chinese Medicine,Zhengzhou 450046)

机构地区：[1]河南中医药大学第一附属医院,郑州450000 [2]河南省病毒性疾病中医药防治重点实验室,郑州450000 [3]河南中医药大学,郑州450046

出　　处：《中国艾滋病性病》2021年第9期965-969,共5页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2017ZX10205502);河南省科技攻关项目(172102310325,182102310264);中国博士后基金项目(2017M612406,2018T110729);河南省中医管理局国家中医临床研究基地专项(2017 JDZX001,2017 JDZX037)。

摘　　要：目的探讨代谢组学技术在同病异证中的诊断价值。方法收集40例艾滋病脾气虚和脾肾亏虚证患者血清,采用超高效液相色谱—四极杆飞行时间串联质谱(UHPLC-Q-TOF-MS)对其代谢产物进行检测,应用主成分分析(PCA)及正交偏最小二乘法-判别分析(OPLS-DA)的方法探讨两组代谢物的差异。结果脾气虚和脾肾亏虚证患者血清代谢物经PCA分析得到7个主成分的模型(R2=0.521,Q2=0.151),模型经OPLS-DA置换检验,R2Y=0.944,Q2=0.892,能够明显将两种证型区分,并确定了14种差异代谢物并涉及花生四烯酸、糖基化磷脂代谢、甘油磷脂代谢、类脂物、嘌呤代谢通路。结论运用代谢组学技术可以将艾滋病脾气虚和脾肾亏虚证明显区分,为艾滋病中医证候辨证分型提供初步参考,同时为"同病异证"及"同病异治"提供实验依据。Objective To explore the diagnostic value of metabolomics in diagnosing the same disease but with different syndromes.Methods Forty AIDS cases were collected fasting serum of patients with spleen-qi deficiency,and UHPLC-Q-TOF-MS detected spleen-kidney deficiency in the morning.The metabolites were investigated by principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA).Results Serum metabolites of patients with AIDS Spleen-qi deficiency and Deficiency of spleen and kidney were analyzed by PCAThe model with seven principal components(R2=0.521,Q2=0.151) and tested by OPLS-DA substitution test.Resultws showed R2Y=0.944.Q2=0.892,which could clearly distinguish the two syndromes.Fourteen different metabolites are involved in arachidonic acid,Glycosylated phospholipid metabolism,glycerolipid metabolism,lipids,purine metabolism pathways.Conclusion The application of metabolomics technology could distinguish spleen-qi deficiency from the deficiency of spleen and kidney in AIDS.Our findings provided a preliminary reference for the syndrome differentiation and classification of TCM syndromes of AIDS and an experimental basis for "different syndromes of the same disease" and "different treatment of the same disease."

关 键 词：代谢组学 艾滋病 同病异证 脾气虚 脾肾亏虚 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]