PDF(Pubmed)
Abstract：
Respiratory distress syndrome (RDS) is a major morbidity of prematurity. In this case-control study, we prospectively evaluated whether untargeted metabolomic analysis (gas chromatography-mass spectrometry) of the gastric fluid could predict the need for surfactant in very preterm neonates. 43 infants with RDS necessitating surfactant (cases) were compared with 30 infants who were not treated with surfactant (controls). Perinatal-neonatal characteristics were recorded. Significant differences in gastric fluid metabolites (L-proline, L-glycine, L-threonine, acetyl-L-serine) were observed between groups, but none could solely predict surfactant administration with high accuracy. Univariate analysis revealed significant predictors of surfactant administration involving gastric fluid metabolites (L-glycine, acetyl-L-serine) and clinical parameters (gestational age, Apgar scores, intubation in the delivery room). Multivariable models were constructed for significant clinical variables as well as for the combination of clinical variables and gastric fluid metabolites. The AUC value of the first model was 0.69 (95% CI 0.57-0.81) and of the second, 0.76 (95% CI 0.64-0.86), in which acetyl-L-serine and intubation in the delivery room were found to be significant predictors of surfactant therapy. This investigation adds to the current knowledge of biomarkers in preterm neonates with RDS, but further research is required to assess the predictive value of gastric fluid metabolomics in this field.
摘要：
呼吸窘迫综合征（RDS）是早产儿的主要发病率。在这项病例对照研究中，我们前瞻性评估了胃液的非靶向代谢组学分析(气相色谱-质谱法)是否可以预测极早产儿对表面活性剂的需要.将43例需要表面活性剂的RDS婴儿（病例）与30例未接受表面活性剂治疗的婴儿（对照）进行比较。记录围产期-新生儿特征。胃液代谢物的显着差异（L-脯氨酸，L-甘氨酸,L-苏氨酸,乙酰-L-丝氨酸）在组间观察到，但没有人能准确预测表面活性剂的给药。单变量分析揭示了涉及胃液代谢物的表面活性剂给药的重要预测因子（L-甘氨酸，乙酰-L-丝氨酸)和临床参数(胎龄，阿普加得分,产房插管)。针对重要的临床变量以及临床变量和胃液代谢物的组合构建了多变量模型。第一个模型的AUC值为0.69（95％CI0.57-0.81），第二个模型的AUC值为0.69，0.76（95%CI0.64-0.86），其中乙酰-L-丝氨酸和产房插管被发现是表面活性剂治疗的重要预测因子。这项调查增加了目前对RDS早产儿生物标志物的了解，但需要进一步的研究来评估胃液代谢组学在该领域的预测价值。
