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目的利用非靶向代谢组学分析方法,探寻重症社区获得性肺炎(SCAP)潜在预后标志物。方法采用液相色谱质谱联用分析技术(LC-MS),对2015年1月至2019年6月收集于北京协和医院的30名健康成人志愿者和68例重症社区获得性肺炎患者的血浆样本进行代谢物检测。根据临床预后,患者可分为存活组(n=49)和死亡组(n=19)。采用多元统计分析方法OPLS-DA和单变量统计分析方法Kruskal Wallis检验筛选差异代谢物。对差异代谢物进行预后分析和相关性分析。结果液相色谱质谱联用分析技术检测出健康成人与重症社区获得性肺炎患者共有代谢物3463个。OPLS-DA和Kruskal Wallis Test分析方法筛选出差异代谢物126个。5-轻色胺(5-HT)在存活组和死亡组间具有显著性差异(P<0.05,AUC>0.75)。5-HT与氧合指数(OI)呈正相关,与急性生理与慢性健康评分II ( APACHEII)呈负相关。结论5-HT能够预测重症社区获得性肺炎患者的预后,可作为预后预测的潜在生物标志物。,Objective To search for potential prognostic markers for severe community-acquired pneumonia(SCAP)using non-targeted metabolomics. Methods Testing plasma samples from 30 healthy people and 68 SCAP patients (all collected from January 2015 to June 2019 at Peking Union Medical College Hospital) by liquid chromatography mass spectrometry(LC-MS ).According to clinical prognosis,patients were divided into survive group (n=49)and non-survive group(n=19).OPLS-DA(multivariate statistical analysis)and Kruskal Wallis Test (single variable statistical analysis) were used to identify differential metabolites. Correlation analysis of clinical indicators and prognostic analysis were also used for differential metabolites. Results Totally 3463 metabolites were detected in healthy people and SCAP patients by LC-MS. Among them, 126 metabolites were screened out by OPLS-DA andKruskal Wallis Test analysis methods. Prognostic analysis showed that the quantity of 5-hydroxytryptamine(5-HT) was significantly different between survive group and non-survive group(P<0.05,AUC>0.75).Correlation analysis of clinical indicators showed that 5-HT was positively correlated with oxygenation index (OI) and negatively cor-related with acute physiology and chronic health evaluation(APACHE II)score. Conclusions The 5-HT as a potential prognostic marker for SCAP,may predict the prognosis of SCAP patients.