Study On Serum Metabonomics Of Acute Pulmonary Embolism Based On Liquid Chromatography-mass Spectrometry

Objective:The liquid chromatography-mass spectrometry(LC-MS)was used to detect the serum samples from acute pulmonary embolism(APE)and healthy people,to identify the significant metabolic products between patients with acute pulmonary embolism and healthy people,to explore the pathophysiological development and pathogenesis mechanism of APE,which can be used for early screening and diagnosis of patients with APE.Methods:1、According to the inclusion and exclusion criteria of this study,15 patients with APE and 14 cases of healthy physical examination were selected respectively as the experimental group and the control group from clinic department of Jilin university first hospital from October 2020 to December 2020,then serum samples were collected from two groups,and the general data and clinical index were collected and then analysed by SPSS21.0.2 、 LC-MS was used to conducted analysis of the whole serum samples,to obtained the serum metabolic profiles and relevant date of APE patients and healthy people.3 、 By reading total ion current and orthogonal partial least squares discrimination analysis(OPLS-DA)chart can roughly know whether APE group and healthy controls had metabolic differences;The possible differential metabolites were determined by S-plot of OPLS-DA、variable importance in the projection and etc.Differential metabolites were analyzed through Human Metabolome database(HMDB)website.The significant metabolics were selected by ROC curve.According to the differential metabolites,possible metabolic pathways were found through Metabo Analysis 5.0 website.Results:1、There were no significant differences in gender、BMI、smoking、alcohol、consumption、 history of hypertension、history of diabetes 、 history of tumor 、LDL-C、HDL-C、TC、TG、UA and creatinine between APE group and healthy control group(p >0.05).However,the history of VTE,age,D-dimer,NT-Pro-BNP,TNT,right ventricular end-diastolic diameter were significantly higher in APE group than healthy control group,and differences are statistiaclly significant(p<0.05).2、There were significant differences in serum metabolic profile between APE group and healthy controls.11 metabolites were selected,including Perfluorooctanoic acid 、 Phenylethylamine 、 Glycerol alpha-monochlorohydrin 、Lyso PC(16:0/0:0)、Lyso PC(18:0/0:0)、PC(20:4(5Z,8Z,11 Z,14Z)/18:3(9Z,12 Z,15Z))、PC(20:4(5Z,8Z,11 Z,14Z)/16:1(9Z))、 2-Aminoacrylic acid 、 Fomepizole 、(2R)-2-Hydroxy-2-methylbutanenitrile and Testosterone.According to the area under the ROC curve,eight important metabolites were further identified.And the area under the curve of phenethylamine was the largest(0.981).The sensitivity and specificity of phenethylamine in the diagnosis of APE were 100% and 92.9%,respectively.3 、 A total of 7 differential metabolic pathways were found through metabo Analyst 5.0 website.Among them,phenylalanine metabolism and glycerophospholipid metabolism pathways were the most related to APE.Conclusions:1、There are 11 kinds of significant difference metabolites between the serum of patients with APE and healthy people.After ROC curve analysis,8 kinds of important difference metabolites were further screened out.They have a good ability to distinguish between patients with APE and healthy people,and may be used as potential biomarkers.Phenethylamine is the best predictor of APE.2.The metabolic pathways of phenylalanine and glycerophospholipid may play significant role in the development of APE.