血质谱分析对失代偿期肝硬化患者的区分价值

Value of blood mass spectrometry analysis in differentiating decompensated liver cirrhosis patients

目的 比较失代偿期肝硬化患者与代偿期肝硬化患者的血质谱差异.方法 选取失代偿期肝硬化患者34例,代偿期肝硬化患者47例,均进行血质谱分析,包括血氨基酸、酰基肉碱和部分比值共93个指标.结果 利用被检测的93个指标进行的多变量统计分析,可以将两组患者明显区分开来.对两组患者区分贡献较大的共有32个指标,其中包括4个化合物比值指标.进一步的Logistic分析提示丙氨酸、十四烯酸肉碱、十四酸二酰肉碱、脯氨酸和丝氨酸5个指标组合足够区分两组患者,受试者工作曲线分析显示上述5个指标组合后,曲线下面积可达0.99.其中除丙氨酸外,其余4个指标均在失代偿患者中显著升高.结论 血代谢物质谱分析可以用于失代偿期与代偿期患者的区分,相应显著变化的化合物可能会为疾病的进展机制研究提供线索.

Objectives To compare the difference of blood mass spectrometry analysis between decompensated liver cirrhosis patients and compensated liver cirrhosis patients. Methods Thirty-four patients with decompensated liver cirrhosis and 47 patients with compensated liver cirrhosis were selected. All patients were analyzed by blood mass spectrometry, and the detected 93 parameters included amino acids, acylcarnitines and some of their ratios. Results After multivariate analysis using the 93 parameters, the two groups could be differentiated clearly. There were 32 parameters that contributed to the separation, which included 4 ratios. Logistic analysis showed that alanine, tetradecanoyl diacylcarnitine, tetradecenoylcarnitine, proline and serine could be used to separate the two groups sufficiently. Receiver operating characteristic curve analysis indicated that the area under the curve generated using the 5 parameters could reach to 0.99. Except alanine, the other 4 metabolites were all increased in the decompensated patients. Conclusions Blood mass spectrometry analysis could be used to differentiate decompensated and non- decompensated cirrhosis patients. The significantly changed metabolites might provide valuable hint in pathological study of the disease.