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摘要: 泌尿系结石是泌尿系统常见的非肿瘤疾病，其逐年升高的患病率和发病率给社会带来沉重的医疗负担，而目前泌尿系结石的确切病因尚未明确，早期诊断、预防及术后随访等均缺乏较简便、易行的方法。代谢组学是继基因组学、蛋白组学和转录组学之后的新兴“组学”，代谢组学通过检测生物体在受到外源刺激或基因修饰后机体内代谢物质的变化，从而探索整个生物体的代谢机制变化。利用代谢组学的方法研究泌尿系结石，有望为泌尿系结石病因、早期诊断、预防及术后随访提供新的思路。本文就代谢组学相关概念和研究方法及其在泌尿系结石方面的基础及临床研究最新进展作一综述。Abstract: Urolithiasis is a common nonneoplastic disease of urinary system, and its increasing prevalence and incidence contribute heavy medical burden to the society. However, the exact etiology of urolithiasis is not yet clear. There are no simple or feasible methods for early diagnosis, prevention and postoperative follow-up. Metabonomics is a new "omics" after genomics, proteomics and transcriptome, which explores the metabolic mechanism of the whole organism by detecting the changes of metabolites in vivo after exogenous stimulation or gene modification. The study of urolithiasis by means of metabonomics is expected to provide new ideas for the etiology, early diagnosis, prevention and postoperative follow-up of urolithiasis. This article reviews the concepts and methods of metabonomics, also the recent basic and clinical progress of metabonomics in urolithiasis.
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Key words:
- metabonomics /
- urolithiasis /
- biomaker
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表 1 不同代谢组学技术的比较
技术 优点 缺点 核磁共振 定量分析 不敏感(LOD=5 μmol/L) 不破坏样本 启动成本高(100万美元) 快速(每个样品2~3 min) 仪器占地面积大 不需要衍生化 无法检测或识别盐和无机离子 无需分离 无法检测非质子化化合物 能检测大多数有机类 需要更大的样品量(0.1~0.5 mL) 允许识别新的化学物质 可识别大多数的光谱特征 强大、成熟的技术 可用于代谢物成像(fMRI或MRS) 可以完全自动化分析 兼容液体和固体 仪器使用寿命长(超过20年) 气相色谱质谱 强大、成熟的技术 破坏样本(样本不可恢复) 启动成本适中(约15万美元) 要求样本衍生化 定量分析(能校准) 需要分离 样品体积适中(0.1~0.2 mL) 慢速(每个样品20~40 min) 良好的灵敏度(LOD=0.5 μmol/L) 不能用于成像 开发有大量的软件和数据库供代谢物鉴定 无法兼容固体 检测大多数有机分子和一些无机分子 新化合物的识别比较困难 良好的分离重现性 可识别大部分光谱特征 大部分可以自动化分析 兼容气体和液体 液相色谱质谱 极高的灵敏度(LOD=0.5 nmol/L) 破坏性(样本不可恢复) 非常灵活的技术 不定量 能检测大多数有机分子和一些无机分子 启动成本较高(30万美元) 样本量小(10~100 μL) 慢速(每个样品15~40 min) 可用于代谢物成像(MALDI或DESI) 通常需要分离 无需分离即可完成(直接注射) 与气相色谱质谱相比，分离分辨率差、重现性低 具有检测大部分的代谢物的潜力 仪器稳定性不如核磁共振或气相色谱质谱 大部分可以自动化分析 与气体不兼容 兼容固体和液体 大多数光谱特征尚无法识别 新化合物的识别比较困难 仪器寿命短(9年) 
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| 引用本文: |
李宾, 吕蔡. 代谢组学与泌尿系结石相关研究新进展[J]. 临床泌尿外科杂志, 2022, 37(1): 74-79. doi: 10.13201/j.issn.1001-1420.2022.01.017
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| Citation: |
LI Bin, LV Cai. New progress in the study of metabonomics and urinary urolithiasis[J]. J Clin Urol, 2022, 37(1): 74-79. doi: 10.13201/j.issn.1001-1420.2022.01.017
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