The Study On Metabolomics Of Strangulated Bowel Obstruction Based On ~1H-NMR

Objective:Strangulated bowel obstruction,as an acute abdomen,needs surgical treatment after its diagnosis.It is difficult to make an early diagnosis and the misdiagnosis rate is high.Precision medicine makes a significant contribution to rapid disease diagnosis and targeted therapy,but relies on detailed,specific clinical information.An individual’s metabolic fingerprint can be obtained by Proton~1H-NMR.The~1H-NMR metabonomics technology was used to detect the blood of strangulated bowel obstruction patients,draw the metabolic fingerprint map of strangulated bowel obstruction,and screen the specific metabolic markers of strangulated bowel obstruction.It can be used for early diagnosis and prognosis of strangulated bowel obstruction,so as to guide surgical treatment and improve prognosis.Methods:We included 30 hospitalized patients with strangulated bowel obstruction as the case group and 30 patients with normal abdominal CT findings excluding the presence of bowel disease as the control group,at the time of admission,5ml of venous blood was collected from the case group and the control group,and the plasma was separated and ~1H-NMR.Principal Component Analysis(PCA),partial least square discriminant analysis(PLS-DA)and orthogonal partial least square discriminant analysis(OPLS-DA)were used to analyze the detected data,the two sets of fingerprints were compared and screened as metabolic markers for early diagnosis and prognosis of strangulated bowel obstruction.The results:Principal Component Analysis(PCA)showed that there were significant differences between the two groups,and 15 principal components were identified.PLS-DA and OPLS-DA were further analyzed,which showed good discrimination between the two groups,and the 5 principal components which had the most significant changes were screened out,five metabolites,Alanine,leucine,L-Isoleucine,lactic acid and Valine,were screened from the database of human metabolism group,and there were significant differences between the two groups(P<0.05),the metabolites were selected as the metabolic markers of strangulated intestinal obstruction.Conclusion:1.Metabolic histology based on ~1H-NMR can be used to screen the prognosis of strangulated bowel obstruction.2.There was significant difference between strangulated Ileus and normal persons.3.Alanine,leucine,L-Isoleucine,lactate and valine in the blood of patients with strangulated bowel obstruction may be potential metabolic markers for early diagnosis of strangulated bowel obstruction.No single metabolite can be used as a possible biomarker for these diseases,and the contribution of the whole ~1H-NMR serum fingerprint appears to be a promising candidate,confirmed in further studies,so it can be used as a first-line method to identify these diseases.