Significance Of Detection Of Urine Organic Acid In Early Diagnosis Of HIE

Objective: To discuss the value of change of urine organic acid in early diagnosis of neonate hypoxic ischemic encephalopathy(HIE).Methods:8 term infant HIE patients(HIE group,marked as U1~U8)taken in for treatment by Neonatal Intensive Care Unit(NICU)of 900 Hospital of Joint Logistics Team of Chinese People's Liberation Army and 10 healthy term infants(control group,marked as N1~N10)were used as research object.3~5ml of urine 0~24h,24~48h and 48~72h after birth were collected with asepsis urine collecting bag,and only 3~5ml of urine 0~24h after birth were collected in the control group.Utilizing the gas chromatography mass spectrography(GC-MS)to determine the value of 132 types of organic acid in urine;utilizing independent sample t to test and compare the difference of urine organic acid values between two groups of neonate and between HIE group at different time points;adopting non-supervision principal component analysis(PCA)method to compare and analyze the difference of principal organic acid component between urine of two groups of neonate;performing descriptive analysis of difference between some organic acid components in urine of two groups of neonate through Heatmap;mating and selecting(mate U7 with N1)0~24h urine of one infant from each group for mass spectrum comparison.Result: The total volume of 0~24h and 24~48h urine organic acid of HIE group is obviously higher than the control group,the difference has statistic significance(Paverage<0.01),48~72h urine organic acid of HIE group is slightly higher than the control group,but the difference has no statistic significance(P>0.05);with elapse of time,the total volume of urine organic acid of HIE group decreases gradually,the total volume of 0~24h urine organic acid is higher than 24~48h,the total volume of 24~48h urine organic acid is higher than 48~72h,and total volume of 48~72h urine organic acid is lower than 0~24h,the difference has statistic significance(P average<0.01).Among the 132 types of detected urine organic acid,values of 24 types of organic acid such as lactic acid,oxalic acid-2 and d glyoxalic acid-OX-2 have statistic significance(P<0.05 or 0.01),most of values of 24 types of organic acid of 0~24h and 24~48h in HIE group are higher than the control group,value of 48~72h is close to the control group;with elapse of time,organic acid value of 24 types of urine organic acid of HIE group decreases gradually,value of 0~24h urine organic acid is higher than 24~48h,and the value of 24~48h urine organic acid is higher than 48~72h.According to PCA comparative analysis of principal component 1(PC1)and principal component 2(PC2)as well as PC1 and principal component 3(PC3),the difference between principal component of 0~24h and 24~48h of HIE group and the control group is prominent,while the difference between 48~72h and the control group is not prominent;discrepancy change of principal component of HIE group occurs with the elapse of time.According to further Heatmap comparison between 24 types of organic acid with difference,cluster analysis shows that organic acids with high abundance value are citric acid,homovanillic acid-2,palmitic acid-1,2-ketoglutaric acid-OX-2,pyruvic acid-OX-2 and aconitic acid-3,which show red in terms of color gradient,in terms of comparison between the 6 types of organic acid,the color gradient of control group is commonly green(monitor index is low abundance),the color gradient of 0~24h and 24~48h of HIE group is commonly red(monitor index is high abundance)and the color gradient of 48~72h is close to the control group.The mating comparison of mass spectrogram of organic acid shows that the abundance and loudness value of total mass spectrogram of HIE infant patient are prominently higher than the control group,and the mass spectrum and loudness value of palmitic acid-1 and aconitic acid-3 of HIE infant patient are prominently higher than the control group.Conclusions:1.The organic acid value in urine 24 h after birth of HIE infant patient rises prominently,then returns to normal gradually afterwards.2.The early detection of change of organic acid in urine may provide assistant criteria for early prediction and interference of HIE.3.Rise of organic acids such as citron acid-4,homovanillic acid-2,palmitic acid-1,2-ketoglutaric acid-OX-2,pyruvic acid-OX-2 and aconitic acid-3 in early urine may be used as assistant index for predicating whether HIE occurs after asphyxiation of neonate.