【摘要】 目的 运用代谢组学方法探究老龄肾阳虚证患者血清特征性生物代谢标志物及相关代谢通路，以期阐明老龄肾阳虚证的本质。方法 收集中医辨证符合老龄肾阳虚证患者15例及同年龄段健康者12例血清样品，采用超高效液相色谱-串联质谱(UPLC-MS/MS)技术检测两组血清样本中代谢物及代谢提取物，并结合主成分分析(principal component analysis,PCA)和正交偏最小二乘法判别分析(orthogonal partial least squares-discriminant Analysis,OPLS-DA)等技术对血清样品进行研究，找出不同代谢物，运用Metaboanalyst 5.0数据处理软件对差异代谢物进行网络分析，聚焦关键代谢通路。结果 代谢组学分析表明老龄肾阳虚证患者血清代谢物轨迹变化明显，通过生物信息学分析，筛选到49种差异代谢物，涉及氮代谢、苯丙氨酸代谢、D-谷氨酰胺代谢、D-谷氨酰胺代谢、丁酸代谢、泛酸酯和CoA合成、酪氨酸、色氨酸、精氨酸、氨基酰-tRNA等多种代谢途径。结论 与同年龄段健康者相比，老龄肾阳虚证患者体内存在着能量代谢、脂肪代谢和氨基酸代谢活动减退的现象，从而呈现出一系列阳热不足的临床病理变化。该研究为揭示老龄肾阳虚本质及病证的临床诊断和治疗提供了重要的信息。更多还原

【Abstract】 Objective By using metabonomics to explore the characteristic biomarkers and related metabolic pathways in the serum of the senior patients with kidney Yang deficiency syndrome. The aim is to clarify the essence of kidney Yang deficiency syndrome in the elderly. Methods Serum samples were collected from 15 elderly patients with kidney Yang deficiency syndrome and 12 healthy people of the same age. The serum data were analyzed by high-performance liquid chromatography-tandem mass spectrometry(UPLC-MS)combined with principal component analysis(PCA)and orthogonal partial least squares-discriminant analysis(OPLS-DA). The differential metabolites were searched and analyzed by Metaboanalyst 5.0 data software in order to focuse on key metabolic pathways. Results Metabolomics analysis exhibited that there had significant altered trajectory in serum metabolites of senior patients with kidney Yang deficiency syndrome,and 49 potential biomarkers were identified,involving D-glutamine and D-glutamate metabolism,nitrogen metabolism,phenylalanine,tyrosine and tryptophan biosynthesis,Arginine biosynthesis,butanoate metabolism,pantothenate and CoA biosynthesis,and aminoacyl-tRNA biosynthesis,etc. Conclusion Compared with the healthy people of the same age,the energy metabolism,fat metabolism and amino acid metabolism decreased in the elderly patients with kidney Yang deficiency syndrome,which presented a series of clinical and pathological changes of deficiency of Yang-heat. The study provides important information for revealing the essence of senior patients with kidney Yang deficiency and the clinical diagnosis and treatment.更多还原