肝衰竭患者呼出气体中标志性化合物与血清生化指标的相关研究

发布时间：2018-04-26 03:27

本文选题：肝衰竭 + 呼出气体　；参考：《南昌大学》2017年硕士论文

【摘要】：目的:应用封闭式电喷雾萃取电离质谱法(EESI-MS)对健康志愿者和肝衰竭患者呼出气体中标志性化合物进行检测研究,并探索其与机体代谢及相应肝衰竭血清生化指标之间的联系与差异。方法:1.分别收集肝衰竭患者(n=23)呼出气和健康志愿者(n=25)的呼出气,采用封闭式EESI-MS进行检测。2.应用偏最小二乘法(PLS)对原始数据进行分析,挑选出有显著差异的变量,在一级指纹谱图中寻找其对应的高分辨分子质量(m/z)。3.对差异变量对应的高分辨分子质量进行二级串联质谱分析,鉴定其可能对应的化合物,并分析与肝衰竭的联系。4.采用SPSS17.0软件对呼气中化合物分子质量分别与肝衰竭生化指标如丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、凝血酶原时间(PT)、凝血酶原活动度(PTA)进行统计分析。结果:1.采用偏最小二乘分析(PLS)处理数据,发现健康志愿者和肝衰竭患者呼出气体有较好的区分,利用模型变量VIP值挑选出24个导致差异最大的变量。2.对差异变量进行二级串联质谱分析,最终确定其10种化合物,分别为异丁烯(m/z 57),丙酮(m/z 59),乙醇醛(m/z 61),异戊二烯(m/z 69),2-丁酮(m/z 73),环戊酮(m/z 85),2,5-二甲基呋喃(m/z 97),2-乙基丙烯酸(m/z 101),6-甲基己烷-2-酮(m/z 115),辛醛(m/z 129)。3.通过对呼气中化合物分子质量与肝衰竭血清生化指标的分析,发现肝衰竭血清生化指标与相应的呼出气体中化合物分子量呈线性相关。结论:1.肝衰竭患者和健康志愿者呼出气体存在有差异的标志性化合物,其中鉴定出的有10种。异丁烯、丙酮、异戊二烯、2-丁酮、环戊酮及乙醇醛可推测出其在体内的代谢过程及与疾病的关系。辛醛、2,5-二甲基呋喃、2-乙基丙烯酸和6-甲基己烷-2-酮仍需更多的研究。2.化合物分子质量与肝衰竭严重程度呈正相关。肝衰竭越严重,肝衰竭患者体内代谢越紊乱,呼出气体中成分越复杂,与患者病情变化相符。
[Abstract]:Objective: to detect the characteristic compounds in the exhaled gases of healthy volunteers and patients with liver failure by closed electrospray extraction ionization mass spectrometry (EESI-MSMS). And to explore the relationship and difference between it and body metabolism and serum biochemical indexes of liver failure. Method 1: 1. The exhaled breath of patients with liver failure (n / n 23) and healthy volunteers (n / n = 25) were collected and detected by closed EESI-MS. The original data were analyzed by partial least square method (PLS), and the variables with significant difference were selected, and the corresponding high resolution molecular mass was found in the first order fingerprint spectrum. The high resolution molecular weight corresponding to the differential variables was analyzed by tandem mass spectrometry, and the possible corresponding compounds were identified, and the relationship between the molecular weight and liver failure was analyzed. Molecular weight of compounds in breath and biochemical parameters of liver failure, such as alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, prothrombin, prothrombin activity, were determined by SPSS17.0 software. PTAs were used for statistical analysis. The result is 1: 1. The partial least square analysis was used to process the data, and it was found that there was a good distinction between healthy volunteers and patients with liver failure. The model variable VIP value was used to select 24 variables that led to the biggest difference. The differential variables were analyzed by two-stage tandem mass spectrometry, and 10 compounds were determined. They are isobutene / z / z 57, acetone / m / z 59, ethyl aldehydes / m / z / z 61, isoprene / m / z 69 and 2-butanone / m / z 73, cyclopentanone / z 85 / m / z, dimethyl furan / m / z 971 / z 971% / z 101mP / z 1011 / 6- methylhexane / 2-one / m / z 115n, octanal / mr / z 129n / m / 3. By analyzing the molecular weight of compounds in breath and serum biochemical indexes of liver failure, it was found that the molecular weight of compounds in the corresponding exhaled gases was linearly correlated with the serum biochemical indexes of liver failure. Conclusion 1. There were significant differences in the exhalation of gases between patients with liver failure and healthy volunteers, of which 10 were identified. Isobutene, acetone, isoprene 2-butanone, cyclopentanone and glycolaldehyde can infer its metabolic process in vivo and its relationship with disease. More studies are needed on 2-ethylacrylic acid and 6-methylhexane-2-one. The molecular weight of the compounds was positively correlated with the severity of liver failure. The more serious the liver failure, the more disorder the metabolism and the more complex the components in the exhaled gas, which are consistent with the changes of the patient's condition.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.3

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