PDF(Pubmed)
Abstract：
We aimed to investigate the characteristics of serum metabolomics in aneurysmal subarachnoid hemorrhage patients (aSAH) with different 3-month outcomes (good = modified Rankin score: 0-3 vs. poor = mRS 4-6). We collected serum samples from 46 aSAH patients at 24 (D1) and 168 (D7) hours after injury for analysis by liquid chromatography-mass spectrometry. Ninety-six different metabolites were identified. Groups were compared using multivariate (orthogonal partial least squares discriminant analysis), univariate, and receiving operator characteristic (ROC) methods. We observed a marked decrease in serum homocysteine levels at the late phase (D7) compared to the early phase (D1). At both D1 and D7, mannose and sorbose levels were notably higher, alongside elevated levels of kynurenine (D1) and increased 2-hydroxybutyrate, methyl-galactoside, creatine, xanthosine, p-hydroxyphenylacetate, N-acetylalanine, and N-acetylmethionine (all D7) in the poor outcome group. Conversely, levels of guanidinoacetate (D7) and several amino acids (both D1 and D7) were significantly lower in patients with poor outcomes. Our results indicate significant changes in energy metabolism, shifting towards ketosis and alternative energy sources, both in the early and late phases, even with adequate enteral nutrition, particularly in patients with poor outcomes. The early activation of the kynurenine pathway may also play a role in this process.
摘要：
我们旨在研究具有不同3个月结局的动脉瘤性蛛网膜下腔出血（aSAH）患者的血清代谢组学特征（良好=改良的Rankin评分：0-3与差=mRS4-6)。我们在受伤后24（D1）和168（D7）小时收集了46例aSAH患者的血清样本，用于液相色谱-质谱分析。鉴定了96种不同的代谢物。使用多变量(正交偏最小二乘判别分析)比较组，单变量，和接收操作员特征(ROC)方法。与早期（D1）相比，我们观察到晚期（D7）的血清同型半胱氨酸水平显着降低。在D1和D7，甘露糖和山梨糖水平明显较高，随着犬尿氨酸（D1）水平升高和2-羟基丁酸增加，甲基半乳糖苷，肌酸,黄苷,对羟基苯基乙酸酯,N-乙酰丙氨酸,和N-乙酰甲硫氨酸（所有D7）在不良结局组。相反，在预后不良的患者中,胍基乙酸盐(D7)和几种氨基酸(D1和D7)水平显著降低.我们的结果表明能量代谢发生了显著变化，转向酮症和替代能源，无论是在早期还是后期，即使有足够的肠内营养，特别是在预后不良的患者中。犬尿氨酸途径的早期激活也可能在该过程中起作用。
