中文摘要：

目的 分析糖皮质激素冲击治疗后系统性红斑狼疮（SLE）患者内源性代谢物的变化。方法 采用气相色谱-质谱联用仪对激素冲击治疗前后SLE患者以及健康对照者血清和尿样中内源性小分子代谢物进行全面检测,利用多变量数据分析和方差分析方法分析组间差异。结果 SLE患者激素冲击治疗前和治疗后血清或尿样可明显区分,且二者均与健康对照明显分簇。糖皮质激素纠正的异常水平代谢物包括血清蛋氨酸、谷氨酸、2-酮基-3-甲基戊酸、2-酮基异己酸,尿中尿素、3,4-二羟基丁酸等,而异常的血清赖氨酸、麦芽糖、乳酸、1-棕榈油酸甘油酯,尿苏氨酸、柠檬酸等体现了激素的副作用。结论 本试验综合评价了与糖皮质激素治疗和副作用相关的代谢物的变化特点,为激素合理用药奠定了基础。

英文摘要：

OBJECTIVE To analyze the changes of endogenous metabolites in patients with systemic lupus erythematosus （SLE） after pulse therapy with glucocorticoids. METHODS Endogenous metabolites in serum and urine of SLE patients before and after pulse therapy with glucocorticoids and healthy subjects were detected by gas chromatography/mass spectrometry, and the differences between the two groups were analyzed by multivariate statistical technique and MANOVA. RESULTS Obvious clustering was observed between serum or urine of SLE patients before and after pulse therapy with glucocorticoids, and both can be clearly distinguished from healthy controls. The metabolites with abnormal levels corrected by glucocorticoids included serum methionine, glutamate, 2-keto-3- methylvalerate, 2-ketoisocaproate, and urinary urea, 3,4-dihydroxybutyrate, etc. While the side effects of glucocorticoids were reflected by abnormal levels of serum lysine, maltose, lactate, 1-monopalmitin,and urinary threonine, citrate, and so on. CONCLUSION In this paper, the change characteristics of endogenous metabolites related to treatment and side effects of glucocorticoids is evalutated comprehensively. These results laid the foundation for rational use of glucocorticoids.