1-棕榈酰溶血磷脂酰胆碱在诊断缺血性心脏病中的价值研究

检验医学 ›› 2012, Vol. 27 ›› Issue (8): 654-658.

1-棕榈酰溶血磷脂酰胆碱在诊断缺血性心脏病中的价值研究

徐维家

1. 大连市中心医院检验科，辽宁大连 116033； 2. 大连市体检中心检验科，辽宁大连 116033

收稿日期:2012-05-17 修回日期:2012-03-14 出版日期:2012-08-30 发布日期:2012-08-08
通讯作者: 徐维家
作者简介:徐维家，男，1953年生，主任技师，主要从事临床生物化学检验工作。

Research on the significance of 1-palmitoyl-sn-glycero-3-phosphocholine in the diagnosis of ischemic heart disease

1. Department of Clinical Laboratory, Dalian Municipal Central Hospital，Liaoning Dalian 116033，China；2. Department of Clinical Laboratory, Dalian Health Examination Center，Liaoning Dalian 116033，China

Received:2012-05-17 Revised:2012-03-14 Online:2012-08-30 Published:2012-08-08

摘要/Abstract

摘要： 目的　筛选缺血性心脏病（IHD）患者血清内发生重要浓度变化的代谢物并探讨其临床价值。方法　检测52例IHD患者和45名正常对照者10项与诊断心肌缺血或梗死有关的血液常规生化指标[包括丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、γ-谷氨酰基转移酶（GGT）、碱性磷酸酶（ALP）、乳酸脱氢酶（LDH）、α-羟丁酸脱氢酶（α-HBDH）、肌酸激酶MB同工酶（CK-MB）、肌酸激酶（CK）、C-反应蛋白（CRP）和心肌肌钙蛋白T（cTnT）]。血清中主要代谢物的代谢组学分析利用高效液相色谱-质谱（HPLC-MS）技术进行。相应数据经统计分析后，筛选并鉴定出有重要变化的代谢物。结果　应用HPLC-MS发现4个平均质荷比（m/z）分别为496.33、478.34、184.13和991.71的离子碎片。经鉴定，4个离子碎片均来自于1-棕榈酰溶血磷脂酰胆碱（C16：0）。IHD组血清1-棕榈酰溶血磷脂酰胆碱（C16：0）浓度为（76.35±18.28）μmol/L，明显高于正常对照组[（64.24±15.56）μmol/L，P＜0.001]。IHD组其他传统心肌指标与对照组比较，除AST升高外（P＜0.05），其余9项均无明显差异（P＞0.05）。受试者工作特性（ROC）曲线显示，诊断IHD时1-棕榈酰溶血磷脂酰胆碱（C16：0）的ROC曲线下面积（0.90±0.03）显著高于其他常规生化指标（P＜0.05）。结论　1-棕榈酰溶血磷脂酰胆碱（C16：0）对IHD具有重要的临床价值。

关键词: 1-棕榈酰溶血磷脂酰胆碱, 缺血性心脏病, 液相色谱-质谱

Abstract: Objective　To screen the most significantly changed metabolite in the sera of patients suffering from ischemic heart disease（IHD）, and investigate its clinical significance. Methods　A total of 10 biochemical parameters involved in the diagnosis of ischemic diseases or infarction were determined including alanine aminotransferase（ALT），aspartate aminotransferase（AST），gamma-glutamyltransferase（GGT），alkaline phosphatase（ALP），lactate dehydrogenase（LDH），alpha-hydroxybutyrate dehydrogenase（α-HBDH），creatine kinase-MB（CK-MB），creatine kinase（CK），C reactive protein（CRP） and cardiac troponin（cTnT） between 52 IHD patients and 45 controls. A strategy of high performance liquid chromatography-mass spectrometry（HPLC-MS） technique was used to explore the major metabolic changes in the sera of the 2 groups in view of metabolomics. The acquired data were subjected to the significance analysis to select and identify the most importantly changed metabolite. Results　The results showed that 4 ion fragments were found between the 2 groups，whose average mass charge ratios （m/z） were 496.33，478.34，184.13 and 991.71. They were finally confirmed to be originated from 1-palmitoyl-sn-glycero-3-phosphocholine（C16：0）. The concentration of this metabolite was （76.35±18.28）μmol/L in IHD patients，which was higher than that in the controls [（64.24±15.56）μmol/L，P＜0.001]. The 9 traditional serum parameters were not different between the patients and the controls（P＞0.05）, except the slightly elevated AST in the IHD group （P＜0.05）. Receiver operating characteristic（ROC） curve indicated that area under the curve of 1-palmitoyl-sn-glycero-3-phosphocholine（C16：0）（0.90±0.03） was larger than that of the other traditional biochemical parameters（P＜0.05）. Conclusions　1-palmitoyl-sn-glycero-3-phosphocholine（C16：0） has clinical significance for the diagnosis of IHD.

Key words: 1-palmitoyl-sn-glycero-3-phosphocholine, Ischemic heart disease, Liquid chromatography-mass spectrometry

徐维家;温　杰;刘　毅 . 1-棕榈酰溶血磷脂酰胆碱在诊断缺血性心脏病中的价值研究[J]. 检验医学, 2012, 27(8): 654-658.

XU Weijia;WEN Jie;LIU Yi . Research on the significance of 1-palmitoyl-sn-glycero-3-phosphocholine in the diagnosis of ischemic heart disease[J]. , 2012, 27(8): 654-658.

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