急性脑梗死患者血浆代谢物的相关性分析

Correlation between plasma metabolites in patients with acute cerebral infarction

目的 探讨血浆代谢物与脑梗死发病的相关性。方法 回顾性连续纳入2017年5月~2018年11月就诊于锦州医科大学附属第一医院接受头部核磁共振成像(MRI)检查的340例住院患者。根据头部MRI是否存在新发脑梗死,分为两组:急性脑梗死组、正常对照组。应用串联质谱法方法检测血浆中93个代谢指标,应用正交偏最小二乘判别分析法(OPLS-DA)、ROC曲线和Logistic回归筛选出两组的差异性代谢物。结果 8个血浆代谢指标和综合指标N与脑梗死发病显著相关,且差异有统计学意义(P<0.05)。各指标在ROC曲线下面积分别为:N(0.977)、Arg(0.833)、Cit/Arg(0.828)、C4DC(0.725)、C18:1(0.787)、C4/C8(0.787)、Met/Phe(0.725)、C26(0.794)、Leu(0.704)。结论 亮氨酸、瓜氨酸、精氨酸、甲硫氨酸、苯丙氨酸、肉碱等可能参与脑梗死的发病机制,研究其代谢过程可能为脑梗死的治疗提供新的临床方向。

Objective To investigate the correlation between plasma metabolites and cerebral infarction. Methods A retrospective review was performed on 340 consecutive inpatients admitted to the first affiliated hospital of jinzhou medical university for head MRI examination from May 2017 to November 2018.According to the presence of new cerebral infarction in the head MRI,they were divided into two groups:acute cerebral infarction group and normal control group. The plasma metabolites were used to detect 93 metabolic markers. Orthogonal partial least-squares discriminant analysis (OPLS-DA),ROC curve and logistic regression were used to screen the differential metabolites. Results Eight plasma metabolic markers and comprehensive index N were significantly associated with cerebral infarction,and the difference was statistically significant ( P < 0.05 ). The areas under the ROC curve for each indicator are:N (0.977),Arg (0.833),Cit/Arg ( 0.828 ),C4DC (0.725),C18:1 (0.787),C4/C8 (0.787),Met/Phe ( 0.725),C26 (0.794),and Leu (0.704). Conclusion Leucine,citrulline,arginine,methionine,phenylalanine and carnitine may be involved in the pathogenesis of cerebral infarction. Studying its metabolic process may provide a new clinical direction for the treatment of cerebral infarction.