新生儿败血症的代谢组学改变：一项探索性临床研究

Metabolomic changes of neonatal sepsis: an exploratory clinical study

摘要:

目的 通过分析新生儿败血症患儿入院后不同时间的血清显著性差异代谢物主要涉及的代谢通路，以探索该病在不同阶段的代谢机制。 方法 选择2019年1月1日至2020年1月1日在湖南省人民医院新生儿科住院的新生儿败血症患儿为败血症组（n=20），采集入院第1天、第4天、第7天的静脉血标本；选择同期健康新生儿为健康对照组（n=10）。采用超高效液相色谱-四级杆飞行时间串联质谱技术对血清标本进行代谢组学分析，探讨不同时间败血症患儿代谢组学变化。 结果 败血症组入院第1天时与健康对照组相比，血清差异代谢物主要涉及萜类骨架的生物合成；败血症组入院第4天时与入院第1天时相比，血清差异代谢物主要涉及丙酮酸代谢；败血症组入院第7天时与入院第4天时相比，血清差异代谢物主要涉及半胱氨酸和蛋氨酸代谢；败血症组入院第7天时与入院第1天时相比，血清差异代谢物主要涉及抗坏血酸代谢。 结论 不同阶段新生儿败血症患儿血清代谢物的代谢机制不同，主要与萜类骨架生物合成、丙酮酸代谢、半胱氨酸和蛋氨酸代谢、抗坏血酸代谢途径相关。 引

Abstract:

Objective To study the metabolic mechanism of neonatal sepsis at different stages by analyzing the metabolic pathways involving the serum metabolites with significant differences in neonates with sepsis at different time points after admission. Methods A total of 20 neonates with sepsis who were hospitalized in the Department of Neonatology, Hunan Provincial People's Hospital, from January 1, 2019 to January 1, 2020 were enrolled as the sepsis group. Venous blood samples were collected on days 1, 4, and 7 after admission. Ten healthy neonates who underwent physical examination during the same period were enrolled as the control group. Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry was used for the metabonomic analysis of serum samples to investigate the change in metabolomics in neonates with sepsis at different time points. Results On day 1 after admission, the differentially expressed serum metabolites between the sepsis and control groups were mainly involved in the biosynthesis of terpenoid skeleton. For the sepsis group, the differentially expressed serum metabolites between days 1 and 4 after admission were mainly involved in pyruvate metabolism, and those between days 4 and 7 after admission were mainly involved in the metabolism of cysteine and methionine. The differentially expressed serum metabolites between days 1 and 7 after admission were mainly involved in ascorbic acid metabolism. Conclusions The metabolic mechanism of serum metabolites varies at different stages in neonates with sepsis and is mainly associated with terpenoid skeleton biosynthesis, pyruvate metabolism, cysteine/methionine metabolism, and ascorbic acid metabolism.