质谱-色谱技术在早产儿蛋白质代谢中的应用研究

Research of protein metabolic products in urine of preterm infants based on the gas chromatography-mass spectrometry

目的利用气相色谱-质谱技术分析早产儿尿液中重要的蛋白质代谢产物(赖氨酸、苯丙氨酸、组氨酸、鸟氨酸、延胡索酸、苹果酸)水平,进而探讨早产儿尿代谢产物特点,为早产儿实现合理的肠道内、外营养提供依据。方法收集2016年7月-2017年12月的47例早产儿(胎龄28~36w)及45例同期分娩的正常足月儿(胎龄37~41w)的尿液标本,利用尿素酶预处理-气相色谱-质谱法(UP-GC-MS)测定2组新生儿尿液中的赖氨酸、苯丙氨酸、组氨酸、鸟氨酸、延胡索酸、苹果酸的水平。结果早产儿组的尿液中赖氨酸、苯丙氨酸以及组氨酸水平均明显低于足月儿组,差异均有统计学意义(P<0.05)。早产儿组的尿液中鸟氨酸、延胡索酸及苹果酸水平均明显低于足月儿组,差异均有统计学意义(P<0.05)。结论早产儿体内存在低水平蛋白质分解代谢,而足月儿的分解代谢水平较早产儿高。测定尿代谢产物可在临床工作中用于评估新生儿体内代谢状况,从而进一步指导临床实施合理的营养支持方案。

Objective To explore the characteristics of metabolic product in the neonates′urine and thus to offer reasonable basis of intestinal nutrition and parenteral nutrition for preterm infant,we analyze the level of some important metabolic product in the newborn babies′urine.They are metabolic products of protein（lysine,phenylalanine,histidine,ornithine,fumaric acid,malic acid）.Methods 47 urine cases were collected from preterm infants（gestational age between 28 weeks and 36 weeks）and 45 cases from fullterm infants（gestational age between 37 weeks and 41 weeks）.We detected the levels of lysine,phenylalanine,histidine,ornithine,fumaric acid,malic acid in their urine by using urease pretreatment-gas chromatography-mass spectrometry（UP-GC-MS）.Results The levels of lysine,phenylalanine and histidine in urine of premature infants were significantly lower than those of full-term infants（P〈0.05）.The levels of ornithine,fumaric acid and malic acid in urine of premature infants were significantly lower than those of full-term infants（P〈0.05）.Conclusion The catabolism levels of protein,carbohydrate and fat in preterm infants is low,while those in full-term infants are higher.The measurement of urine metabolic products can assess the newborns′ metabolic status.Thus it can guide reasonable nutritional support in clinical work.