基于气相色谱-质谱分析难治性肺炎支原体肺炎湿热证型非靶标代谢组学研究

Study on refractory mycoplasma pneumonia with dampness-heat syndrome by non-targated metabolomics method based on GC-MS

目的:以代谢组学为视角探寻难治性肺炎支原体肺炎(RMPP)湿热证潜在生物标志物及相关代谢通路。方法:对17例PMPP湿热证患儿及17名同期健康儿童观察相关实验室指标,气相色谱-质谱(GC-MS)分析血清代谢组变化,多元统计分析筛选组间差异代谢物,并进行KEGG代谢通路富集分析。结果:RMPP湿热组患儿血清C反应蛋白(CRP)、降钙素原(PCT)、乳酸脱氢酶(LDH)水平较对照组显著升高(P<0.05)。GC-MS筛选出尿素、甘油、麦芽糖、D-果糖、4-乙酰氨基丁酸等13个潜在代谢标志物。涉及精氨酸和脯氨酸代谢、甘油脂代谢、淀粉与蔗糖代谢、果糖与甘露糖代谢、嘌呤代谢等代谢通路。结论:RMPP湿热组患儿血清CRP、PCT、LDH水平较高,为RMPP的湿热证的早期识别提供依据;初步得出的组间差异性标志物可能为RMPP湿热证的证候本质奠定物质基础。

Objective:To explore the potendial biomarkers and related metabolic pathways of refractory mycoplasma pneumonia(RMPP)by the perspective of metabolomics.Methods:This study observed relevant laboratory indicators of 17 RMPP children and 17 health children.Gas chromatography-mass spectrometry(GC-MS)was performed on the serum metabonomics,the differential metabolites between groups were screened by multivariate statistical analysis,and enrichment analysis of KEGG metabolic pathway was also performed.Results:Serum CRP,PCT and LDH levels of children in RMPP group were significantly higher than those in control group(P<0.05).Thirteen metabolites were screened out by GC-MS,among them,the most significant metabolites were Urea,glycerol,maltose,D-Fructose,4-acetamidobutanoic acid and others.It involves arginine and proline metabolism,glyceride metabolism,starch and sucrose metabolism,fructose and mannose metabolism,purine metabolism and other metabolic pathways.Conclusion:The serum levels of CRP,PCT and LDH in children with RMPP were relatively high,which provided evidence for the early identification of RMPP syndrome of dampness-heat.The preliminarily obtained intergroup difference markers may lay a material foundation for the syndrome essence of RMPP.