腹膜透析首次腹腔感染脾肾气虚证和气阴两虚证患者血清氨基酸水平变化分析

Analysis on Changes of Serum Amino Acid Levels in Patients with Spleen-Kidney-Qi Deficiency Syndrome and Qi-Yin Deficiency Syndrome for First Abdominal Infection on Peritoneal Dialysis

目的:比较腹膜透析首次腹腔感染脾肾气虚证与气阴两虚证患者血清氨基酸水平的差异,为中医证型量化提供标准。方法:收集2015年1月—2019年12月绍兴第二医院肾病科治疗的腹膜透析首次腹腔感染患者,根据中医辨证属脾肾气虚和气阴两虚证者,记录两组患者的临床参数,超高效液相色谱-串联质谱检测血清氨基酸水平。结果:共收集腹膜透析首次腹腔感染患者227例,其中脾肾气虚组87例,气阴两虚组69例。与气阴两虚组相比,脾肾气虚组血清中C反应蛋白、犬尿氨酸水平较低,白蛋白、血钙、色氨酸及精氨酸水平较高,差异均有统计学意义(均P<0.05)。结论:腹膜透析首次腹腔感染脾肾气虚证与气阴两虚证患者存在明显的氨基酸代谢紊乱,通过筛查差异氨基酸可为中医辨证提供帮助。

Objective:To compare the differences in serum amino acid levels between patients with spleen-kidney-qi deficiency syndrome and qi-yin deficiency syndrome for the first abdominal infection on peritoneal dialysis,and to provide a standard for the quantification of TCM syndrome types.Methods:Collected patients with peritoneal dialysis first-associated abdominal cavity infection treated in the nephrology department of Shaoxing Second Hospital from January 2015 to December 2019.According to TCM differentiation,patients with spleen-kidney-qi deficiency syndrome and qi-yin deficiency syndrome were collected,and the clinical parameters of patients in the two groups were recorded.Ultra performance liquid chromatography-tandem mass spectrometry was used to detect serum amino acid levels.Results:A total of 227 patients with first-time abdominal infection on peritoneal dialysis were collected,including 87 patients in the spleen-kidney-qi deficiency group and 69 patients in the qi-yin deficiency group.Compared with the qi-yin deficiency group,the serum C-reactive protein and kynurenine levels in the spleen-kidney-qi deficiency group were lower,and the albumin,blood calcium,tryptophan and arginine levels were higher,and the differences were statistically significant(All P<0.05).Conclusion:Patients with spleen-kidney-qi deficiency syndrome and qi-yin deficiency syndrome for the first time on peritoneal dialysis have obvious amino acid metabolism disorders.The screening of differential amino acids can provide help for TCM syndrome differentiation.