A Metabonomic Study Of Acute ST Segement-Elevation Myocardial Infarction

Objective:By using ultra performance liquid chromatography mass spectrometry（UPLC-MS）technology,the criminal coronary serum and peripheral arterial serum of patients with ST segment elevation myocardial infarction（STEMI）treated by thrombus aspiration were analyzed to try to establish relevant disease models and screen potential biomarkers that may be related to the disease,And try to understand the pathophysiological mechanism of the disease from the perspective of metabolism.Methods:In this experiment,UPLC-MS was used to analyze the criminal coronary serum samples（thrombus aspiration group）and their own peripheral artery group of twelve STEMI patients who received coronary thrombus aspiration therapy.After peak processing,arrangement,normalization and other pretreatment by Thermo Scientific sieve software,and then using SIMCA software to obtain the total ion map for preliminary identification of the differences between the samples of the two groups,unsupervised principal component analysis（PCA）was established to analyze the variability of metabolite data.Furthermore,characteristic ions between two samples that meet the VIP value > 3 and P < 0.01 are screened by variable important in the projection（VIP）,confidence interval of variables in PCA load diagram,and non-parametric test.The relevant information of characteristic ions was compared with relevant standard products on HMDB website to determine the final differential metabolites.In addition,the metabolic pathway analysis function was used on Metabo Analyst 5.0 to find the metabolic pathway related to different metabolites.Results:1.By observing the established PCA model,we can see that the metabolites in the thrombus aspiration group and the peripheral artery group are aggregated,and the metabolites between the groups are obviously separated.Therefore,it is recognized that the metabolites in the serum samples of the two groups are different,and there are metabolic differences.2.We finally screened 22 related differential metabolites（10 in ESI+ mode and12 in ESI-mode）,glycerol phospholipid and sheath phospholipid related metabolites were up-regulated.Cer（d18:0 / 22:0）was significantly down regulated.3.According to the metabolic pathway analysis of Metabo Analyst website,it is concluded that the differential metabolites obtained from the experiment widely exist in the metabolic pathways such as glycerol phospholipid metabolism,sheath phospholipid metabolism and linoleic acid metabolism,among which glycerol phospholipid and sheath phospholipid metabolism are the most closely related to STEMI.Conclusions:1.In this experiment,LC-MS metabonomics method was successfully used to separate and compare the criminal coronary artery and peripheral artery of STEMI patients,and 22 different metabolites were screened.By observing the changes of local metabolites of STEMI coronary thrombosis,we have a preliminary understanding of the pathophysiological mechanism of STEMI.2.Many metabolic pathways are involved in the occurrence and development of STEMI,among which the metabolic changes of glycerol phospholipids and sheath phospholipids are more obvious.3.The metabolism of glycerol phospholipid and sheath phospholipid may play an important role in the occurrence and development of STEMI and in the process of local plaque rupture and local acute thrombosis.Whether their intermediate products can be used as potential markers of STEMI for clinical diagnosis and prognosis analysis needs further exploration and research.