串联质谱法观察慢性阻塞性肺疾病患者外周血氨基酸水平变化特点

The characteristics of amino acid levels in peripheral blood of patients with COPD by tandem mass spectrometry

目的采用串联质谱法观察不同严重程度慢性阻塞性肺疾病(简称慢阻肺)患者外周血氨基酸水平变化特点。方法收集锦州医科大学附属第一医院2020年5月至2020年8月收治的慢阻肺患者99例,根据肺功能结果将患者分为GOLDⅠ/Ⅱ组、GOLDⅢ组和GOLDⅣ组。另选择同期30例健康体检者作为对照组。基于液相色谱–串联质谱(LC-MS)方法对慢阻肺患者和对照组外周血氨基酸进行检测。结果11种氨基酸与慢阻肺的发病相关,并且随着病情加重,氨基酸的代谢差异更为显著,其中支链氨基酸(亮氨酸、缬氨酸)在不同GOLD分级慢阻肺患者中差异均有统计学意义(P<0.05且VIP>1)。谷氨酸及谷氨酰胺仅于GOLDⅣ期的差异有统计学意义(P<0.05且VIP>1)。酪氨酸、苯丙氨酸的含量随着病情的加重而逐渐增加,并于GOLDⅣ期差异有统计学意义(P<0.05)。结论不同GOLD分级的慢阻肺患者均存在明显的氨基酸代谢紊乱,包括必需氨基酸摄入不足以及与肌肉蛋白分解代谢有关的氨基酸的增加。了解氨基酸代谢与慢阻肺之间的发生机制可能为疾病的诊断及治疗提供新的方向。

Objective Tandem mass spectrometry is used to observe the changes in amino acids level in peripheral blood of patients with chronic obstructive pulmonary disease(COPD) of different severity, and explore the related factors that affect the level of amino acids in COPD patients. Methods A collection of 99 COPD patients from the First Affiliated Hospital of Jinzhou Medical University between May 2020 and August 2020 were divided into GOLDⅠ/Ⅱ group, GOLD Ⅲ group and GOLD Ⅳ group according to the results of their lung function. Thirty healthy physical examination subjects during the same period were enrolled as a healthy control group. Peripheral amino acids were detected by liquid chromatography-tandem mass spectrometry(LC-MS). Results The metabolism of 11 amino acids was correlated with the onset of COPD and the disorder of amino acid metabolism became more significant with the aggravation of the disease, and branched-chain amino acids(leucine, valine) had statistically significant differences in the COPD patients with different GOLD grades(P<0.05 and VIP>1). The difference between glutamate and glutamine was statistically significant only in GOLD Ⅳ stage(P<0.05 and VIP>1). The content of tyrosine and phenylalanine gradually increased with the increase of disease severity, and had significant difference in GOLD stage Ⅳ(P<0.05).Conclusions COPD patients with different GOLD grades have obvious amino acid metabolism disorders, including insufficient intake of essential amino acids and increased amino acids related to muscle protein catabolism. Understanding the mechanism between amino acid metabolism and COPD may provide a new direction for the diagnosis and treatment of the disease.