基于代谢组学研究新生儿黄疸患者及对蓝光治疗的反应

池敏珊 柯美容 张晓敏

【摘要】 目的：探讨新生儿黄疸患者光照前后血清代谢谱学变化，为进一步研究新生儿黄疸和光疗反应代谢谱学提高依据。方法：选取本院30例新生儿黄疸患者为新生儿黄疸组，25例健康新生儿为正常对照组。运用核磁共振（NMR）的代谢组学方法来研究生儿黄疸组光疗前后与正常对照组的血清代谢谱差异。数据通过多因素的主成分分析（PCA）和正交偏最小二乘判别分析（OPLS-DA）进行处理。结果：依据PCA和OPLS-DA模型鉴别，新生儿黄疸组与正常对照组比较有缬氨酸、肌醇、赖氨酸、亮氨酸等10种代谢物存在差异;新生儿黄疸组治疗前后有β-葡萄糖、α-葡萄糖、缬氨酸、酪氨酸等28种代谢物存在差异。结论：新生儿黄疸患者的代谢紊乱，且光疗对脂质、氨基酸和能量代谢的影响具有重要的作用。

【关键词】 新生儿黄疸; 光疗法; 代谢组学; 核磁共振波谱

【Abstract】 Objective：To explore the changes of serum metabolic spectrum in neonatal jaundice patients before and after illumination，and to improve the basis for further study of neonatal jaundice and phototherapy response metabolic spectrum.Method：A total of 30 neonatal jaundice patients were selected as neonatal jaundice group and 25 healthy neonates as normal control group.The metabolomics method of nuclear magnetic resonance（NMR）was used to study the difference of serum metabolic spectrum between Jaundice group and normal control group before and after phototherapy.Data were processed by principal component analysis（PCA）and orthogonal partial least squares discriminant analysis（OPLS-DA）.Result：According to the identification of PCA and OPLS-DA models，there were 10 metabolites such as valine，inositol，lysine and leucine in the neonatal jaundice group compared with the normal control group，there were 28 metabolites such as β-glucose，α-glucose，valine and tyrosine in the neonatal jaundice group before and after treatment.Conclusion：Metabolic disorders in neonatal jaundice patients，and the effects of phototherapy on lipid，amino acid and energy metabolism play an important role.

【Key words】 Neonatal jaundice; Phototherapy; Metabonomics; Nuclear magnetic resonance spectroscopy

First-authors address：Nanshan Peoples Hospital，Shenzhen 518052，China

doi：10.3969/j.issn.1674-4985.2019.16.003

黃疸是一种新生儿最常见的疾病。据估计，大约60%的足月婴儿和80%的早产儿在出生后的第1周出现黄疸[1-2]。光疗通常被认为是一种安全和耐受性良好的治疗新生儿黄疸的方法，可以将胆红素转化为水溶性的异构体，很容易通过胃肠道或尿液丢失消除[3-4]。胆红素在460 nm波长附近的蓝色区域吸收最强烈的光，氮化镓光致发光二极管（LED）可提供高强度的窄波长光谱光，已被越来越多地用于治疗新生儿黄疸[5-6]。虽然光疗可有效治疗新生儿黄疸，但很少有评估光疗有效性的生物标志物，2004年美国儿科学会发布的光疗指南，主要是参考血清总胆红素（TSB）水平的高低[7]。……