轻微肝性脑病患者血清代谢组研究.docVIP

轻微肝性脑病患者血清中代谢物组的研究 齐素文1，涂植光1Δ，戴勇1，欧阳昕2，彭武建2，蔡安季1 (400016 重庆，重庆医科大学教育部重点实验室，临床医学检验诊断实验室1； 510632 广东深圳，暨南大学第二临床医学院深圳市人民医院 临床医学研究中心2) [摘要 目的 采用核磁共振（NMR）方法检测肝硬化患者（肝硬化组）、轻微肝性脑病患者（MHE组）清中的代谢物，研究3组样本血清代谢物组的差异，初步建立MHE诊断模型。方法 应用主成分分析（PCA）和正交偏最小二乘法-判别分析(OPLS-DA)对NMR谱数据进行模式识别分析，并用临床标本验证代谢组模型诊断MHE的可行性。结果 与相比，肝硬化组和MHE组患者血清中葡萄糖、琥珀酸盐、柠檬酸盐等含量增高, 低密度脂蛋白极低密度脂蛋白、胆碱等含量减少；与肝硬化组相比，MHE组患者的血清中的谷氨酰胺、苯丙氨酸、丙酮增高，缬氨酸和异亮氨酸降低。OPLS-DA分析结果显示肝硬化与健康对照组肝硬化组MHE组均可开来，临床标本验证模型诊断MHE的准确率为80%。结论 基于1H NMR代谢组学技术可同时检测患者血清中多种代谢物质，有助于研究肝硬化和MHE的发病机制，有可能为MHE的诊断提供一种新的手段。 中图分类Study on Metabolic Signature of Serum in Patients with Minimal Hepatic Encephalopathy Qi Suwen1, Tu Zhguang1Δ, Dai Yong1, Ouyang Xin2, Peng Wujian2, Cai Anji1 (1. Key laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing, 410006; 2. Center of Clinical medicine, Second Clinical Medical College, Jinan University, Guangdong, 510632) ABSTRACT: Objective To compare the metabonomics in the serum samples from 25 1iver cirrhosis patients, 25 cirrhotic patients with minimal hepatic encephalopathy (MHE) and 30 healthy volunteers based on the method of nuclear magnetic resonance spectroscopy (NMR) and to establish a diagnostic model for MHE. Methods Principal component analysis (PCA) and orthogonal partial least-squares-discriminant analysis (OPLS-DA) were employed to perform the pattern recognition analysis of NMR spectra. Clinical samples were used to evaluate the performance of the diagnostic model. Results In comparison with healthy volunteers，the results showed that patients of liver cirrhosis and MHE were characterized by increased levels of glucose, succinate, citrate, etc and decreased levels of low-density lipoprotein and VLDL,very low-density lipoprotein, choline, etc. Compared with cirrhotic patients without MHE, patients with MHE showed increased glutamine, phenylalanine, acetone and decreased valine and isoleucine. The OPLS-DA models were capable of distinguishing between healthy con