慢性浅表性胃炎脾气虚与脾胃湿热证患者尿液1H-NMR的代谢组学研究

Metabonomics Study on Urine 1H-NMR in Chronic Superficial Gastritis Patients with Pi-qi Deficiency Syndrome/Pi-Wei Dampness-heat Syndrome

目的观察慢性浅表性胃炎（chronic superficial gastritis,CSG）脾气虚及脾胃湿热证患者尿液代谢组学变化,为两种中医证型的科学辨证提供依据。方法分别收集CSG脾气虚证、脾胃湿热证患者（各10例）和健康志愿者（10名）的尿液进行核磁共振氢谱（proton nuclear magnetic resonance spectroscopy,~1HNMR）检测,综合采用多变量统计学方法中主成分分析（principal component analysis,PCA）、偏最小二乘判别分析（partial least square discriminant analysis,PLS-DA）及单变量统计分析方法测定相关代谢标志物的含量。结果 PLS-DA显示,脾气虚证、脾胃湿热证患者及健康志愿者尿液代谢状态可相互区分,在脾气虚证患者和健康志愿者尿液中共筛选得到谷氨酸、甲硫氨酸、α-酮戊二酸、二甲基甘氨酸、肌酐、牛磺酸及葡萄糖7种差异代谢产物;在脾胃湿热证患者和健康志愿者尿液中筛选得到2-羟基丁酸、氧化三甲胺、牛磺酸、马尿酸4种差异代谢产物;在脾气虚证和脾胃湿热证患者中筛选得到岩藻糖、β-羟基丁酸、丙氨酸、谷氨酸、甲硫氨酸、琥珀酸、柠檬酸、肌酐、葡萄糖、乳酸及马尿酸11种差异代谢产物。结论 CSG脾气虚证与脾胃湿热证患者的代谢差异主要体现在糖代谢、脂类代谢、氨基酸分解代谢方面,基于1H-NMR的代谢组学技术可用于临床不同中医证型的分类研究。

Objective To observe metabolomic changes in urine of chronic superficial gastritis（ CSG） patients with Pi-qi deficiency syndrome（ PQDS） or Pi-Wei dampness-heat syndrome（ PWDHS）,thereby providing scientific evidence for syndrome typing of them. Methods Urine samples were collected from CSG patients with PQDS / PWDHS and healthy volunteers,10 in each group. Proton nuclear magnetic resonance spectroscopy（~1H-NMR） based metabonomic analysis was performed on urine samples. Contents of related biomarkers were analyzed by principal component analysis（ PCA）,partial least square discriminant analysis（ PLS-DA）,and urivariate statistical analysis. Results PLS-DA analysis showed that metabolites among CSG patients with PQDS / PWDHS and healthy volunteers could be mutually distinguished. Seven differentially identified metabolites were screened from urines of CSG patients with PQDS and healthy volunteers included glutamate,methionine,α-oxoglutarate, dimethylglycine, creatinine, taurine, and glucose. Four differentially identified metabolites were screened from urines of CSG patients with PWDHS and healthy volunteers included 2-hydroxybutyric acid,trimethylamine oxide,taurine,and hippuric acid. Eleven differentially identified metabolites were screened from urines of CSG patients with PQDS and PWDHS included fucose,β-hydroxybutyric acid,alanine,glutamate,methionine,succinic acid,citric acid,creatinine,glucose,hippuric acid,and lactic acid. Conclusion The metabolic differences of CSG patients PQDS and PWDHS mainly manifested in glycometabolism,lipid metabolism,and amino acids catabolism,and1H-NMR based metabonomics may be used in classified study of Chinese medical syndrome typing.