摘要
目的联合非靶向和靶向代谢组学技术检测创伤性脑损伤(traumatic brain injury,TBI)差异代谢物,并评估其与病情严重程度及预后的关系。方法选取徐州医科大学附属医院2022年8月至12月就诊的TBI患者(TBI组)和体检健康者(健康人对照组)各40例,应用超高效液相色谱-线性离子阱/静电场轨道阱组合式高分辨质谱(UPLC/LTQ Orbitrap Velos MS)筛选并验证差异代谢物。记录40例TBI患者入院12 h内格拉斯哥昏迷评分(glasgow coma scale,GCS)和伤后6个月格拉斯哥预后评分(glasgow outcome scale,GOS),结合差异代谢物评估疾病严重程度和预后。结果验证的4个差异代谢物(谷氨酸、尿酸、肌酐和乳酸)存在显著分离趋势,TBI组谷氨酸和乳酸水平显著高于健康人对照组,尿酸和肌酐水平显著低于健康人对照组;随着伤情加重,TBI患者谷氨酸和乳酸水平逐渐升高,尿酸和肌酐水平逐渐降低;影响预后不良的4种代谢物组ROC曲线下面积(AUC ROC)为0.818,敏感性为76.9%,特异性为81.5%(P<0.05)。结论谷氨酸、乳酸、尿酸和肌酐与TBI患者病情密切相关,四者联合或可用于预测TBI的预后。
Objective To discover the differential metabolites of traumatic brain injury(TBI)by combined application of untargeted and targeted metabolomics techniques,and evaluate the relationship of the differential metabolites with the severity and prognosis of disease condition.Methods A total of 40 TBI patients and 40 healthy subjects were selected in the Affiliated Hospital of Xuzhou Medical University from August 2022 to December 2022.UPLC/LTQ Orbitrap Velos MS was used to screen and verify the differential metabolites.The Glasgow coma scale(GCS)within 12 hours after admission and Glasgow outcome scale(GOS)in 6 months after injury were recorded in 40 TBI patients.The severity and prognosis of the injury condition were evaluated combined with the differential metabolites.Results Four potential biomarkers(glutamate,uric acid,creatinine and lactate)were validated to present significant separation trend by combined analysis for both the untargeted and targeted metabolites.The levels of glutamate and lactate in TBI group were significantly higher than those in control group,but the levels of uric acid and creatinine were significantly lower than those in control group.With the aggravation of TBI state,the levels of glutamate and lactic acid gradually increased and the levels of uric acid and creatinine gradually decreased.The area under the ROC curve of the four metabolite groups suggestive of poor prognosis was 0.818 with the sensitivity of 76.9%and the specificity of 81.5%(P<0.05).Conclusion The levels of glutamate,lactic acid,uric acid and creatinine should be closely related to the condition of TBI patients,and their combined evaluation can be used to predict the prognosis of TBI patients.
作者
周惠惠
程桂青
田璐
周愿
李洪春
ZHOU Huihui;CHENG Guiqing;TIAN Lu;ZHOU Yuan;LI Hongchun(School of Medical Technology,Xuzhou Medical University,Xuzhou 221004,Jiangsu;Department of Laboratory Medicine,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu,China)
出处
《临床检验杂志》
CAS
2023年第7期530-536,共7页
Chinese Journal of Clinical Laboratory Science
基金
徐州医科大学优秀人才科研启动基金项目(D2018016)。
