Based On UPLC-MS Technology, Preliminary Study Of AECOPD Phlegm-heat Obstructing Lung Syndrome Metabolism Pattern Characteristics

Chronic obstructive pulmonary disease(COPD),a common respiratory disease,is characterized by airflow limitation,which is often incomplete reversible and continuous.The disease can be controlled by early prevention and aggressive treatment.China is a high-risk area for COPD.9.9%of adults have COPD after 40 years of age.Acute exacerbation chronic obstructive pulmonary disease(AECOPD)is one of the most common fatal respiratory diseases in China.It is caused by external environmental infections and manifests as cough,cough,wheezing,difficulty breathing,etc.Patients with more severe airway inflammation have respiratory failure,which further aggravates dyspnea,and patients with decreased immunity and malnutrition have a poor prognosis.Western medicine treats the disease mainly with anti-infective drugs and symptomatic supportive treatment.The curative effect is relatively stable,but the commonly used inhaled hormonal drugs may lead to an increased risk of lung infection,and there are adverse reactions such as osteoporosis and immunosuppression,which limit its clinical use.The basic and in-depth clinical research of COPD is what our research group has been pursuing for a long time.At present,we have a systematic and in-depth understanding of the pathogenic factors,etiology and pathogenesis,syndrome elements and TCM treatment of COPD.However,the current understanding of the connotation of modern micro-thinking of the AECOPD syndrome is still not very clear.My College of Chinese Medicine,Beijing University of Traditional Chinese Medicine has a well-established metabolomics analysis platform.Therefore,our research team uses metabolomics,a modern biological science research technology,combined with clinical lung function,blood routine examination and symptom evaluation,to explore a basic research on the syndromes of phlegm and blood stasis syndrome.Objective:On the one hand,the ultra-high performance liquid chromatography mass s pectrometer(UPLC-MS)technique was used to study the metabolites of serum sample-s from patients with AECOPD and heat-sickness syndrome,and to explore AECOPD.The essence of the syndrome of pulmonary syndrome;on the other hand,the metaboli-c model of AECOPD,heat-sickness and lung-stagnation syndrome is explored,and it is expected to establish a syndrome differentiation method that can be used in clinica-1 combination of TCM macroscopic and Western medicine microscopic,TCM syndro-me observation and Western medicine examination indicators,and provide an effective target for AECOPD TCM syndrome differentiation and treatment.Method:Including 46 patients with acute exacerbation of chronic obstructive pulmon ary disease in Beijing(26 cases of phlegm-heat-sickness syndrome,20 cases of non-he at-sickness-sickness syndrome),10 healthy volunteers,collected after informed consent 2 ml of fasting peripheral venous blood,standing at room temperature,centrifuged to take the upper serum,stored in a refrigerator at-80 ?,and analyzed by ultra-high p erformance liquid chromatography-mass spectrometry,using a combination of principal component analysis,multidimensional analysis and single-dimensional analysis.Differen tial metabolites between groups were screened(VIP>2,p<0.05).Compound structu res were screened by METLIN,KEGG,LIPID MAPS and Chemspider,and MetPA w as substituted for differential metabolite pathway analysis to explore the evidence base of AECOPD'sphlegm-heat obstructing lung.Results:Compared with the healthy control group,patients with acute exacerbation of chronic obstructive pulmonary disease found 53 kinds of small molecular metabolite-s with varying concentration and specific gravity,mainly involved in 9 related metab olic pathways such as arachidonic acid metabolism and glycerophospholipid metabolism.Compared with the non-tempering and silicosis syndrome group,the lung syndrome gr-oup found that there were 50 small molecule metabolites with different concentration and specific gravity,mainly related to seven related metabolic pathways such as sphin golipid metabolism,glycerophospholipid metabolism and linoleic acid metabolism.Conclusion:1.UPLC-MS technology can better distinguish the metabolic patterns of AECOPD and healthy human serum.The serum of patients with acute exacerbation of chronic obstructive pulmonary disease can be seen in the body of three major energy substances such as phospholipids,fatty acids and amino acids.Changes have occurred,mainly in the metabolism of glycerophospholipids,and metabolic pathways such as arachidonic acid are disturbed.2.There are differences in small molecule metabolites and metabolic pathways between different types of AECOPD syndromes.The sphingolipid metabolism and glycerophospholipid metabolism are mainly involved in the serum of patients with AECOPD and phlegm syndrome.