代谢组学在泌尿系结石中的研究现状与展望

Current status and prospects of the study of metabolomics in urolithiasis

泌尿系结石属于泌尿外科常见病、多发病,有高患病率、高复发率等特点,且成石原因复杂,难以以单一学说定论。代谢组学是一门阐明生物体代谢相关过程的新兴组学技术,可用来阐述生物体内代谢产物及其生理、病理变化,寻找特定生物标志物及其代谢通路,为疾病的诊断、预防等提供新思路。目前,代谢组学亦广泛应用于泌尿系结石的相关研究中,丰富了泌尿系结石的研究方法。文章以代谢组学在泌尿系结石中的研究现状为切入点,概述目前常见的研究思路,发现代谢组学在泌尿系结石中的应用主要是通过简化式评估,即应用血清学检查、尿液检查和结石成分分析等检查方法,开展动物实验或临床研究,分析干预前后生物体内代谢产物变化,寻找潜在生物学标记物,探究成石原因及评估药物、手术治疗疗效。考虑到代谢组学概念与中医整体观念、辨证论治的部分相似性,已有研究将代谢组学同中医证候联系起来,但该项技术在泌尿系结石中医证候研究中应用极少。因此,文章提出可将代谢组学引入泌尿系结石中医证候的研究中,比较不同证型间代谢产物、代谢通路的差异,以期找到各证型间客观的特殊代谢产物,为泌尿系结石发病机制、诊疗方案及中医证候标准化研究提供思路和方向。

Urolithiasis is a common and frequently occurring disease in urology,with high prevalence rate and high recurrence rate,and the cause of stone formation is complex,so it is difficult to be determined by a single doctrine.Metabolomics is an emerging technology to elucidate the metabolism-related processes in organisms,which can be used to elucidate the metabolites and their physiological and pathological changes in organisms,to search for specific biomarkers and their metabolic pathways,and to provide new ideas for diagnosis and prevention of diseases.At present,metabolomics is also widely used in the study of urolithiasis,which enriches the study methods of urolithiasis.This paper takes the current research status of metabolomics in urolithiasis as the starting point,summarizes the current common research ideas,and finds that the application of metabolomics in urolithiasis is mainly through simplified evaluation,that is,serological examination,urine examination and stone component analysis are used to carry out animal experiments or clinical studies,and analyze the changes of metabolites in biological bodies before and after intervention,to search for potential biological markers,explore the causes of stone formation,and evaluate the efficacy of drug and surgical treatment.In view of the similarity between the concept of metabolomics and the holistic concept and differential treatment of TCM,some studies have linked metabolomics with TCM syndromes,but this technology has rarely been applied in the study of TCM syndromes of urolithiasis.Therefore,this paper proposes that metabolomics could be introduced into the study of TCM syndromes of urolithiasis to compare the differences of metabolites and metabolic pathways among different syndromes,in order to find objective specific metabolites among different syndromes,and to provide ideas and directions for the study of the pathogenesis,diagnosis and treatment plan,and standardization of TCM syndromes of urolithiasis.