首诊尿毒症患者用串联质谱法分析血氨基酸和酰基肉碱

Analysis of Amino Acids and Acylcarnitines in the Blood of Patients First Diagnosed with Uremia Using Tandem Mass Spectrometry

目的用串联质谱分析方法检测首次诊断尿毒症未行替代治疗患者的血氨基酸和酰基肉碱值,为临床诊疗提供依据.方法选取30例首次诊断尿毒症患者为研究对象,即尿毒症组(研究组),健康体检者15例为对照组.利用串联质谱技术分析2组血中11种氨基酸及2种酰基肉碱数值,并分析统计数据.结果研究组与对照组血丙氨酸(Ala)及酪氨酸(Tyr)在2组间的差异有统计学意义(P<0.05),其中研究组显著低于正常组.血瓜氨酸(Cit)、甘氨酸(Gly)、脯氨酸(Pro)在2组间的差异有统计学意义(P<0.05),其中研究组显著高于正常对照组.2组间有统计学差异的氨基酸以非必需氨基酸为主.血游离肉碱和总肉碱在2组间的差异有统计学意义(P<0.05),2个指标在尿毒症患者组均显著高于正常对照组.结论对于首次诊断尿毒症未行替代治疗患者,其血部分氨基酸代谢紊乱,并且以非必需氨基酸为主.其肉碱水平均高于正常高线,其分析结果可以为临床营养治疗提供依据.

Objective Analyze the amino acids and acylcarnitines in the blood of patients first diagnosed with uremia using tandem mass spectrometry in order to provide a basis for clinical diagnosis and treatment. Methods 30 patients with uremia were selected as the research objects, while 15 cases of healthy person were served as the control. The values of 11 kinds of amino acids and 2 kinds of acylcarnitines in the two groups were detected using tandem mass spectrometry,and the data were analyzed and compared. Results The levels of alanine（Ala） and tyrosine（Ty）r in uremia group were significantly lower than those in control group（P〈0.05）, while the levels of citrulline（Ci）t,glycine（Gly） and proline（Pro） were significantly higher in uremia group than in control group（P〈0.05）. The differences were mainly in non-essential amino acids between the two groups. The levels of free carnitines and total carnitines in uremia group were significantly higher than those in normal group（P〈0.05）.Conclusion For the patients first diagnosed with uremia（not treated with replacement therapy）, the disturbance of amino acid metabolism mainly in non-essential amino acids were found in their blood,and the carnitine levels were higher than normal levels. The results could provide the basis for clinical nutrition therapy for patients with uremia.