基于液相色谱-质谱联用技术的社区获得性肺炎合并脓毒症患者血清脂质组学分析  

Serum lipidomics analysis of patients with community-acquired pneumonia complicated with sepsis based on liquid chromatography-mass spectrometry

作　　者：田红军[1] 徐喜媛[1] 吕娜 杨敬平[1] TIAN Hong-jun;XU Xi-yuan;LV Na;YANG Jing-ping(Department of Respiratory and Critical Care Medicine,the Third Affiliated Hospital of Inner Mongolia Medical University,Baotou,Inner Mongolia 014016,China)

机构地区：[1]内蒙古医科大学第三附属医院呼吸与危重症医学科,内蒙古包头014016

出　　处：《临床肺科杂志》2022年第12期1862-1867,共6页Journal of Clinical Pulmonary Medicine

基　　金：包头市科技基金项目(2019Z3010-12)。

摘　　要：目的 高通量测试脂质在社区获得性肺炎合并脓毒症患者血液中的含量,筛选出可能作为社区获得性肺炎合并脓毒症诊断的生物标志物。方法 将我院呼吸与危重症医学科确诊的社区获得性肺炎合并脓毒症患者30例及同时段健康体检志愿者16例纳入研究,对外周血进行质谱分析,检测脂质分子的类型、代谢产物的含量变化,并对相关的脂质代谢基因进行定量检测,通过统计学分析,评估脂质分子及相关代谢基因的变化对社区获得性肺炎合并脓毒症的诊断价值。结果 社区获得性肺炎合并脓毒症患者血浆中脂质分子LPA18:2、LPA20:4、LPC16:0、LPC18:2、LPE16:0、LPE18:2、LPE18:1、S1P、LPC18:1、LPC18:0及LPE18:0低表达且负相关(均P<0.004);Cer16:0、Cer18:0、Cer20:0高表达且正相关(均P<0.003)。LPA 18:2、LPA 18:0、LPE 18:1及LPE16:0与社区获得性肺炎合并脓毒症相关性较强,模拟预测的准确度为分别为:0.95、0.89、0.87及0.86。社区获得性肺炎合并脓毒症患者血浆中的脂质代谢相关基因ATX、LIPH、LPP、LPEAT2、PLA2表达变化显著(均P<0.001)。结论 LPA 18:2、LPA 18:0、LPE 18:1及LPE16:0及脂质代谢相关基因可作为筛查社区获得性肺炎合并脓毒症的候选分子标志物。Objective To obtain the content of lipid in blood of patients with community-acquired pneumonia complicated with sepsis through high-throughput test,and to screen out biomarkers that could diagnose community-acquired pneumonia complicated with sepsis.Methods 30 cases who had been confirmed with community-acquired pneumonia and purulent poison in the Pulmonary of Critical Care Medicine and 16 cases of health check-up volunteers at the same time were included in the study.Their peripheral blood was given mass spectrographic analysis to detect molecular type and content changes in metabolite,and the related lipid metabolic genes were given quantitative test.Through statistically analysis,the changes in lipid molecules and related metabolic genes were evaluated to the diagnostic value of community-acquired pneumonia complicated with sepsis.Results Lipids molecule-LPA18:2,LPA20:4,LPC16:0,LPC18:2,LPE16:0,LPE18:2,LPE18:1,S1P,LPC18:1,LPC18:0 and LPE18:0 were low-expressed and negatively correlated in patients with community-acquired pneumonia complicated with sepsis(P<0.004).Cer16:0,Cer18:0 and Cer20:0 were highly expressed and positively correlated(P<0.003).LPA 18:2,LPA 18:0,LPE 18:1 and LPE16:0 were strongly correlated with patients with community-acquired pneumonia complicated with sepsis.The accuracy of simulation prediction was 0.95,0.89,0.87 and 0.86,respectively.The expressions of lipid metabolism-related genes ATX,LIPH,LPP,LPEAT2 and PLA2 in plasma of patients with community-acquired pneumonia complicated with sepsis changed significantly.Conclusion LPA 18:2,LPA 18:0,LPE 18:1,LPE16:0 and lipid metabolism-related genes can be used as candidate markers for screening the patients with community-acquired pneumonia complicated with sepsis.

关 键 词：社区获得性肺炎合并脓毒症 脂质组学 生物标志物 液相色谱-质谱联用 qPCR 

分 类 号：R563.1[医药卫生—呼吸系统] R459.7[医药卫生—内科学]