不同证型更年期综合征妇女血浆 UPLC － QTOF/MS代谢组学特征研究王 燕，翟 琪，佟玉静(河北省唐山市人民医院，河北 唐山 063001)［摘要］ 目的 研究肾阴虚型、肝气郁结型及肝肾阴虚型更年期综合征妇女血浆超高效液相色谱 － 四极杆飞行时间串联质谱(UPLC － QTOF/MS)代谢组学特征，探讨 UPLC － QT-OF/MS 代谢组学技术在妇女更年期综合征中医分型中的应用价值。方法 对肾阴虚型、肝气郁结型、肝肾阴虚型更年期综合征妇女及健康同龄妇女各 25 例的血浆样品进行 UPLC －QTOF/MS 检测，建立正交偏最小二乘法判别分析(OPLS － DA)模型，比较不同证型更年期综合征妇女血浆代谢物谱的差异，寻找潜在的生物标志物。结果 OPLS － DA 分析表明，不同证型更年期综合征及健康同龄妇女血浆 UPLC － QTOF/MS 代谢物谱能够被明确区分，鉴定出包括氨基酸、脂肪酸、磷脂、糖类、酯类以及醇类等 16 个潜在生物标志物在 3 组中存在明显差异。与健康同龄妇女相比，不同证型更年期妇女血浆内 3 种氨基酸含量异常(P ＜0． 05)，8 种脂肪酸及有机酸类含量异常(P ＜0． 05)，磷脂、醇类、酯类、酮体及糖类各 1 种含量异常(P ＜0． 05)，不同证型更年期妇女发生明显氨基酸代谢、脂肪酸代谢、磷脂代谢、能量代谢以及糖代谢等代谢紊乱。结论 不同证型更年期综合征妇女血浆 UPLC － QTOF/MS 代谢物谱存在显著差异，能从代谢组学分析中确定其特异生物标志物，据此在一定程度上区分更年期综合征的不同中医证型。［关键词］ 更年期综合征;血浆;超高效液相色谱 － 四极杆飞行时间串联质谱;代谢组学;生物标志物doi:10．3969/j． issn． 1008 －8849． 2017． 26．008［中图分类号］ Ｒ588 ［文献标识码］ A ［文章编号］ 1008 －8849(2017)26 －2874 －05Metabolomic study on climacteric women with different syndrome patterns based on UPLC-QTOF/MSWANG Yan，ZHAI Qi，TONG Yujing(Tangshan people’s hospital，Tangshan 063001，Hebei，China)Abstract:Objective It is to study UPLC-QTOF/MS metabolomic characteristics of climacteric women with deficiency ofkidney Yin，stagnation of liver Qi，and deficiency of liver-kidney Yin pattern，and to explore the application of UPLC-QTOF/MS metabonomics in research of syndrome pattern classification on climacteric syndrome． Methods Plasma samples from 25climacteric women with deficiency of kidney Yin，stagnation of liver Qi，and deficiency of liver-kidney Yin patterns，as well ashealthy age-matched women were determined by UPLC-QTOF/MS respectively． The model of OPLS-DA was established to ex-plore the differences of plasma metabolite profiling of climacteric women with different syndrome patterns，and to find potentialbiomarkers． Ｒesults OPLS-DA showed that metabolite profiling based on UPLC-QTOF/MS of climacteric women with differentsyndrome patterns could be clearly classified，and there existed 16 potential biomarkers including amino acids，fatty acids，phospholipids，carbohydrates，esters and alcohols which showed significant differences among three groups． Compared with thehealthy age-matched women，the contents of 3 kinds of amino acids，8 kinds of fatty acids and organic acids，one kind ofphospholipid，alcohol，ester，ketone and carbohydrate showed significant differences among climacteric women with differentsyndrome patterns (P ＜0． 05)，which suggested that climacteric women with different syndrome patterns occurred metabolicdisorders of amino acids，fatty acids，phospholipids，energy and carbohydrate． Conclusion The metabolite profiling based onUPLC-QTOF/MS of climacteric women with different syndrome patterns showed significant differences，so we could determinethe specific biomarkers by metabolomic analysis，and classify climacteric syndrome with different syndrome patterns to someextent．Key words:climacteric syndrome;plasma;UPLC-QTOF/MS;metabolomics;biomarkers［作者简介］ 王燕，女，主治医师，研究方向为恶性肿瘤、女性更年期相关症候群。更年期综合征指妇女在绝经前后，雌激素水平出现波动，由此导致的以自主神经系统功能紊乱为主要症状，并伴有神经性心理症状的一组症候群 ［1］ 。据 WHO 调查，约有 80% 的· 4 7 8 2 · 现代中西医结合杂志 Modern Journal of Integrated Traditional Chinese and Western Medicine 2017 Sep，26(26)
