Toczylowska Beata, Kalinowski Piotr, Kacka-Piotrowska Agata, Duda Paulina, Grąt Michał, Zieminska Elzbieta
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, Poland.
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
Int J Mol Sci. 2025 Mar 18;26(6):2719. doi: 10.3390/ijms26062719.
The aim of this study was to gain insight into the biochemical status of cerebrospinal fluid in the presence of brain death in life-supported patients. The biochemical status was determined via in vitro NMR spectroscopy of cerebrospinal fluid (CSF) obtained by lumbar puncture from 22 patients with confirmed brain death and compared with that of 34 control patients (without neurological diseases). Forty-one NMR signals from raw CSF samples and 20 signals from lipid extracts were analyzed using univariate and multivariate statistical methods. ANOVA revealed significant differences in all analyzed signals. No single biochemical marker was found to predict brain death. The CSF metabolic profiles of patients who died differed significantly from those of patients in the control group. There were many statistically significantly different compounds, including amino acids, ketone bodies, lactate, pyruvate, citrate, guanidinoacetate, choline, and glycerophosphocholine. Analysis of lipids revealed significant differences in cholesterol, estriol, and phosphoethanolamine. Discriminant analysis allows the analysis of metabolic profiles instead of single biomarkers of cerebrospinal fluid compounds. The results of our analysis allowed us to split the groups-the control group, which consisted of patients with a normal biochemical CSF composition, and the brain death group-with confirmed brain death.
本研究的目的是深入了解接受生命支持的脑死亡患者脑脊液的生化状态。通过对22例确诊脑死亡患者经腰椎穿刺获取的脑脊液进行体外核磁共振波谱分析来确定生化状态，并与34例对照患者（无神经系统疾病）的脑脊液进行比较。使用单变量和多变量统计方法分析了原始脑脊液样本中的41个核磁共振信号以及脂质提取物中的20个信号。方差分析显示所有分析信号均存在显著差异。未发现单一生化标志物可预测脑死亡。死亡患者的脑脊液代谢谱与对照组患者的代谢谱存在显著差异。有许多在统计学上有显著差异的化合物，包括氨基酸、酮体、乳酸、丙酮酸、柠檬酸、胍基乙酸、胆碱和甘油磷酸胆碱。脂质分析显示胆固醇、雌三醇和磷酸乙醇胺存在显著差异。判别分析允许对脑脊液化合物的代谢谱而非单一生物标志物进行分析。我们的分析结果使我们能够将这些组分开——对照组由脑脊液生化组成正常的患者组成，以及确诊为脑死亡的脑死亡组。
