摘要
目的探讨支气管肺发育不良(bronchopulmonary dysplasia,BPD)早产儿出生36 h内尿代谢产物的特点,为BPD寻找出生早期的预警指标.方法选择2014年1月至2016年10月中山大学附属第六医院收治、出生胎龄<32周、住院时间>28 d且在出生36 h内留取尿液标本进行代谢产物检测的早产儿进行回顾性分析.确诊BPD的早产儿为BPD组,按1∶1比例从未发生BPD的早产儿中选取与BPD组相同胎龄和日龄的早产儿为对照组,均应用气相色谱-质谱联用技术进行尿代谢产物测定.采用正交偏最小二乘判别分析法对数据进行分析,应用受试者工作特征曲线和曲线下面积分析差异代谢物联合预测分数预测BPD的价值.结果BPD组和对照组各纳入20例进入分析.出生后36 h内BPD组尿中岩藻糖、酒石酸水平(nmol/mg Cr)低于对照组[0.00(0.00,0.03)比0.07(0.00,0.41),0.00(0.00,0.01)比0.02(0.00,0.06)],犬尿氨酸、胸腺嘧啶水平(nmol/mg Cr)高于对照组[0.04(0.00,0.43)比0.00(0.00,0.00),7.10(0.00,14.47)比0.00(0.00,0.22)],差异均有统计学意义(P<0.05).受试者工作特征曲线分析显示联合4种代谢物预测BPD的曲线下面积为0.857(95%CI0.732~0.982).结论早产儿岩藻糖、胸腺嘧啶、犬尿氨酸、酒石酸等尿代谢物变化可能与BPD发生发展有关,早期联合检测4种代谢物在早期诊断BPD中具有潜在应用前景,可能预警BPD的发生.
Objective To study the characteristics of urinary metabolites in the premature infants with or without bronchopulmonary dysplasia(BPD)within 36 hours after birth and to find new biomarkers for the early warning indicators for BPD.Method From January 2014 to October 2016,premature infants hospitalized in the Sixth Affiliated Hospital of Sun Yat-sen University with gestational age<32 weeks,hospitalization time>28 days and urine samples were collected within 36 hours after birth for metabolite detection were enrolled in the study.Preterm infants diagnosed as BPD were selected as the BPD group.Preterm infants with the same gestational age,days of age with the BPD group had no BPD were selected as the control group at a ratio of 1∶1.The gas chromatography-mass spectrometry was used to measure the metabolites.The data were analyzed using orthogonal partial least squares discriminant analysis and receiver operating characteristic(ROC)curve and the area under which were used to determine the performance of differential metabolites in the diagnosis of BPD.Result There were 20 patients in the BPD group and 20 patients in the control group.Within 36 hours after birth,in the BPD group,the level of fucose and tartrate in urine(nmol/mgCr)were significantly lower than that in the control group[0.00(0.00,0.03)vs.0.07(0.00,0.41);0.00(0.00,0.01)vs.0.02(0.00,0.06),respectively].The level of kynurenic acid and thymine(nmol/mgCr)were significantly higher than the level in the control group[0.04(0.00,0.43)vs.0.00(0.00,0.00);7.10(0.00,14.47)vs.0.00(0.00,0.22),respectively].All the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve for the diagnosis of BPD in combination with the four metabolites was 0.857(95%CI 0.732~0.982).Conclusion Changes in urinary metabolites such as fucose,thymine,kynurenine and tartaric acid in preterm infants may be related to the development of BPD.Early detection of these four metabolites has potential in the early diagnosis of BPD,and may warn agains
作者
黄培练
李思涛
郝虎
马飞
肖昕
Huang Peilian;Li Sitao;Hao Hu;Ma Fei;Xiao Xin(Department of Pediatrics,Sicth Afiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China;Department of Pediatrics,People's Hospial of Baiyun District,Guangzhou 510500,China)
关键词
支气管肺发育不良
气相色谱•质谱法
代谢组学
婴儿
早产
Bronchopulmonary dysplasia
Gas chromatography-mass spectrometry
Metabolomics
Infant,premature
