PDF(Pubmed)
Abstract：
Delayed diagnosis of patients with sepsis or septic shock is associated with increased mortality and morbidity. UPLC-MS and NMR spectroscopy were used to measure panels of lipoproteins, lipids, biogenic amines, amino acids, and tryptophan pathway metabolites in blood plasma samples collected from 152 patients within 48 h of admission into the Intensive Care Unit (ICU) where 62 patients had no sepsis, 71 patients had sepsis, and 19 patients had septic shock. Patients with sepsis or septic shock had higher concentrations of neopterin and lower levels of HDL cholesterol and phospholipid particles in comparison to nonsepsis patients. Septic shock could be differentiated from sepsis patients based on different concentrations of 10 lipids, including significantly lower concentrations of five phosphatidylcholine species, three cholesterol esters, one dihydroceramide, and one phosphatidylethanolamine. The Supramolecular Phospholipid Composite (SPC) was reduced in all ICU patients, while the composite markers of acute phase glycoproteins were increased in the sepsis and septic shock patients within 48 h admission into ICU. We show that the plasma metabolic phenotype obtained within 48 h of ICU admission is diagnostic for the presence of sepsis and that septic shock can be differentiated from sepsis based on the lipid profile.
摘要：
脓毒症或脓毒性休克患者的延迟诊断与死亡率和发病率增加相关。UPLC-MS和NMR光谱用于测量脂蛋白组，脂质，生物胺，氨基酸,和色氨酸途径代谢物的血浆样本收集的152名患者在48小时内进入重症监护病房（ICU），其中62名患者没有败血症，71例患者有败血症，19例患者出现感染性休克。与非脓毒症患者相比，脓毒症或脓毒性休克患者的新蝶呤浓度较高，HDL胆固醇和磷脂颗粒水平较低。根据10种不同的脂质浓度，可以将败血症性休克与败血症患者区分开来，包括五种磷脂酰胆碱的浓度明显降低，三种胆固醇酯，一个二氢神经酰胺,和一种磷脂酰乙醇胺.所有ICU患者的超分子磷脂复合物（SPC）均减少，而脓毒症和脓毒性休克患者在入住ICU48小时内急性期糖蛋白的复合标志物升高。我们表明，在ICU入院48小时内获得的血浆代谢表型可诊断败血症的存在，并且可以根据血脂谱将败血症休克与败血症区分开。
