基于血清代谢组学探究3D打印技术辅助下微创手术治疗对高血压性脑出血患者的影响  

Exploring the Impact of Minimally Invasive Puncture Therapy Assisted by 3D Printing Technology on Patients with Hypertensive Cerebral Hemorrhage Based on Serum Metabolomics

作　　者：宋燕飞 王同聚 王建格 张荣凯 刘欢 杨吉鹏[2] SONG Yanfei;WANG Tongju;WANG Jiange;ZHANG Rongkai;LIU Huan;YANG Jipeng(Department of Neurosurgery,Lincheng County People's Hospital,Lincheng County,Xingtai,Hebei 054300,China;Department of Neurosurgery,The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省临城县人民医院神经外科,河北临城054300 [2]河北医科大学第二医院神经外科,河北石家庄050000

出　　处：《转化医学杂志》2024年第4期516-520,539,共6页Translational Medicine Journal

基　　金：河北省医学科学研究课题计划(20221600)。

摘　　要：目的采用超高效液相色谱-质谱(UPLC-MS)联用的方法探究3D打印技术辅助下微创手术治疗对高血压性脑出血患者及相关代谢通路的影响。方法选取河北省临城县人民医院2022年1月至2023年8月128例高血压性脑出血患者作为研究对象,按照随机数字表法分研究组(64例,接受3D打印技术辅助的微创血肿清除术)和对照组(64例,接受传统开颅血肿清除手术)。比较2组术中出血量、手术时间、血肿清除率,术前和术后7 d、1个月及3个月美国国立卫生研究院卒中量表(NIHSS)评分,术前和术后7 d血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL–6)、C反应蛋白(CRP)和血清脑源性神经营养因子(BDNF)水平,收集血清样本进行代谢组学分析。结果与对照组比较,研究组手术出血量减少,手术时间缩短,血肿清除率更高,术后7 d血清BDNF水平更高,TNF-α、IL-6、CRP水平更低,比较差异均有统计学意义(P<0.05)。代谢组学分析表明,研究组与对照组代谢水平比较差异有统计学意义(P<0.05),差异代谢物分析找出110个显著变化的代谢物,涉及多类别,京都基因和基因组百科全书(KEGG)富集分析显示这些代谢物涉及多种关键生物过程。结论3D打印技术辅助的微创手术治疗对高血压性脑出血患者有较好代谢调控效果。Objective To explore the impact of minimally invasive puncture therapy assisted by 3D printing technology on patients with hypertensive cerebral hemorrhage and analyze the related metabolic pathways using the ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)combined method.Methods This study selected 128 patients with hypertensive cerebral hemorrhage who were treated in Lincheng County People's Hospital from January 2022 to August 2023.They were randomly divided into an experimental group(64 cases,receiving minimally invasive hematoma removal assisted by 3D printing technology)and a control group(64 cases,receiving traditional craniotomy for hematoma evacuation).The intraoperative blood loss,operation time,hematoma clearance rate,pre-and post-operative NIHSS scores of the two groups were compared,and the serum levels of TNF-α,IL-6,CRP,and brain-derived neurotrophic factor(BDNF)on the 7th day after the operation were recorded.Serum samples were collected for targeted metabolomics analysis.Results Compared with the control group,the experimental group had less intraoperative blood loss,shorter operation time,and better hematoma clearance effect(P<0.05).The serum BDNF level increased on the 7th day after the operation,while the levels of inflammatory biomarkers(TNF-α,IL-6,CRP)decreased(P<0.05).Non-targeted metabolomics analysis showed that there were significant differences in the metabolic levels between the experimental group and the control group(P<0.05).Differential metabolite analysis identified 110 significantly changed metabolites involving multiple categories.KEGG enrichment analysis indicated that these metabolites play critical roles in biological metabolism.Conclusions Minimally invasive puncture therapy assisted by 3D printing technology showed better metabolic regulation effects in patients with hypertensive intracerebral hemorrhage.The changes of metabolites and enriched metabolic pathways provide new perspectives for improving treatment strategies and researching disease mechanisms.

关 键 词：颅内出血 高血压性 炎性因子 最小侵入性外科手术 打印 三维 代谢组学 

分 类 号：R734.340.5[医药卫生—肿瘤]