急性心肌梗死患者血清代谢物谱的筛选研究

Investigation of serum metabolic profiling in acute myocardium infarction

目的 分析急性心肌梗死（AMI）患者血清代谢轮廓,寻找早期诊断急性心肌梗死的代谢指标.方法 病例对照研究.收集2011年5月至2012年3月天津市第三中心医院住院确诊的AMI患者42例及同期体检的健康成人35名采用超高效液相色谱与质谱联用（UPLC-MS）代谢组学研究平台筛选特征代谢物,利用SPSS17.0软件进行统计分析,同时利用ROC曲线对特征代谢物的临床诊断效能进行评估.结果 构建了“急性心肌梗死患者-健康对照组”的主成分分析（R2X=75.6％,Q2 =39.7％）及正交偏最小二乘代谢轮廓分析模型（R2Y=97.8％,Q2=97.0％）并鉴定了19个差异代谢物,其中甘油磷脂类物质在AMI患者血清中均呈下调趋势,而鞘磷脂类物质大部分均呈上调趋势,鉴定出的代谢物的曲线下面积均大于0.8,验证结果模型的预测准确度达到100％.结论 利用代谢轮廓分析方法所找到的特征代谢物具有很好的区分AMI患者与健康人群的能力,可以作为潜在的疾病诊断标志物及新治疗靶点在临床领域做进一步研究.

Objective To evaluate the serum metabolic profiling of acute myocardium infarction （AMI） patients,establish a disease distinguishing model and to select characteristic metabolites with potential clinical diagnostic value.Methods All 42 AMI patients and contemporaneous 35 healthy physical examination adults from May 2011 to March 2012 at the Third Central Hospital of Tianjin.UPLC-LTQ Orbitrap XL MS platform filter characteristics of metabolites.SPSS 17.0 was used for statistical analysis.ROC curve was established to assess the clinical diagnostic value of selected characteristic metabolites.Results PCA （R2X =75.6％,Q2 =39.7％） model and OPLS-DA （R2Y =97.8％,Q2 =97.0％） model were established and 19 ions were identified.Glycerophospholipids decreased in AMI group and sphingophospholipids increased in AMI group.The areas under the curve of all identified metabolites were greater than 0.8.Conclusion Metabolites selected in metabolic profiling analysis show outstanding ability in distinguishing AMI from health people and can be used as potential diagnostic biomarkers and benefit in further clinical study as novel drug targets