肺炎患者血清能量代谢产物的变化及其临床意义  

Changes and significance of serum energy metabolites in patients with pneumonia

作　　者：唐建辉 晋小祥 郁帆 李明旭 朱国清 杨志军 Tang Jianhui;Jin Xiaoxiang;Yu Fan;Li Mingxu;Zhu Guoqing;Yang Zhijun(Department of Critical Care Medicine,Deyu Medical Maanshan General Hospital,Maanshan 243000,China)

机构地区：[1]德驭医疗马鞍山总医院重症医学科,马鞍山243000

出　　处：《中华实验外科杂志》2024年第7期1579-1582,共4页Chinese Journal of Experimental Surgery

基　　金：2022年度皖南医学院科研项目(LC202204)。

摘　　要：目的探讨肺炎患者血清能量代谢产物的变化及对预后的价值和临床意义。方法选取2020年9年至2022年9月德驭医疗马鞍山总医院收治的50例肺炎患者作为研究对象, 选取50例健康者作为对照研究。根据患者预后情况分为预后良好组(29例)和预后不良组(21例)。收集两组患者外周血, 分离血清, 采用代谢组学分析患者外周血中能量代谢相关产物的变化;比较不同预后、不同病情程度患者能量代谢产物的变化。采用多因素Logistic回归分析预后相关的独立影响因素;分析外周代谢物水平对预后诊断的价值。组间计量数据比较采用独立样本t检验。结果对照组患者外周血中乳酸、甘油醛3-磷酸、磷酸二羟基丙酮、磷酸烯醇式丙酮酸相对水平(1.29±0.25、1.74±0.57、1.15±0.27、1.14±0.28)明显低于肺炎组(4.61±1.17、3.46±0.77、2.50±0.53、2.66±0.81), 差异有统计学意义(t=19.570、12.630、16.190、12.600, P<0.05)。对照组患者外周血中乙酰辅酶A、柠檬酸、a-酮戊二酸相对水平(1.38±0.41、1.60±0.38、1.29±0.27)明显高于肺炎组(0.44±0.19、1.00±0.90、0.67±0.19), 差异有统计学意义(t=14.610、8.918、13.170, P<0.05)。对照组患者外周血中核酮糖-5磷酸相对水平(1.42±0.21)明显高于肺炎组(0.62±0.21), 差异有统计学意义(t=19.110, P<0.05)。重症组和预后不良组患者外周血中乳酸、甘油醛3-磷酸、磷酸二羟基丙酮、磷酸烯醇式丙酮酸相对水平(5.53±0.94、3.98±0.71、2.81±0.51、3.53±0.76;5.83±0.67、4.22±0.41、2.97±0.33、3.38±0.45)明显高于轻症组和预后良好组(3.68±0.39、2.94±0.39、2.20±0.34、2.04±0.33;3.74±0.38、2.91±0.41、2.16±0.34、2.14±0.56), 差异有统计学意义(t=9.040、6.344、4.999、9.218, P<0.05;t=14.230、11.200、8.432、8.299, P<0.05)。重症组和预后不良组患者外周血中乙酰辅酶A、柠檬酸、a-酮戊二酸相对水平(0.38±0.12、0.80±0.25、0.57±0.15;0.32±0.12、0.7Objective To investigate the changes of serum energy metabolites in patients with pneumonia and its prognostic value and clinical significance.Methods FTotally,50 patients with pneu-monia treated from September 2020 to September 2022 were selected as the study objects,and 50 healthy subjects were selected as the control group.The patients were divided into good prognosis group(29 cases)and bad prognosis group(21 cases).Peripheral blood was collected from the two groups,serum was sepa-rated,and metabolomics was used to analyze the changes of energy metabolism-related products in periph-eral blood of the patients.The changes of energy metabolites in patients with different prognosis and disease severity were compared.Multivariate Logistic regression was used to analyze the independent prognostic factors.The value of peripheral metabolite level in prognostic diagnosis was analyzed.Independent-Sample t test was used to compare measurement data between groups.Results The relative levels of lactic acid,glyceraldehyde 3-phosphate,dihydroxyacetone phosphate and phosphoenolpyruvate in peripheral blood of control group(1.29±0.25,1.74±0.57,1.15±0.27,1.14±0.28)were significantly lower than those of pneumonia group(4.61±1.17,3.46±0.77,2.50±0.53,2.66±0.81,t=19.570,12.630,16.190,12.600,P<0.05).The acetyl CoA,citric acid,a-ketone glutaric acid relative levels of peripheral blood in the control group(1.38±0.41,1.60±0.38,1.29±0.27)were significantly higher than pneumonia group(0.44±0.19,1.00±0.90,0.67±0.19)(t=14.610,8.918,13.170,P<0.05).The relative level of ribulose-5 phosphate in peripheral blood of control group(1.42±0.21)was significantly higher than that of pneumonia group(0.62±0.21,t=19.110,P<0.05).The relative levels of lactic acid,glyceraldehyde 3-phosphate,dihydroxyacetone phosphate and phosphoenolpyruvate in peripheral blood of patients in severe group and poor prognosis group(5.53±0.94,3.98±0.71,2.81±0.51,3.53±0.76;5.83±0.67,4.22±0.41,2.97±0.33,3.38±0.45)were significantly higher than mild and go

关 键 词：肺炎 糖酵解 三羧酸循环 磷酸戊糖途径 预后 

分 类 号：R563.1[医药卫生—呼吸系统]