【目的】 探究缺血性中风患者和健康人在舌苔脂质代谢物方面的差异，筛选出存在于缺血性中风患者舌苔中的潜在生 物标志物。【方法】 选取20例明确诊断为缺血性中风的患者作为观察组，另选取20例同期的健康体检者作为对照组，年龄均 在40～80岁之间。运用超高分辨液相色谱-质谱联用（UHPLC-MS）技术，并结合主成分分析（PCA）、偏最小二乘法判别分析 （PLS-DA）等统计分析方法，对观察组和对照组的舌苔样本进行非靶向脂质代谢组学研究，根据基于正交信号校正的偏最小 二乘法判别分析（OPLS-DA）模型中VIP值大于1以及Wilcoxon秩检验的P值小于0.05的标准，筛选并确定具有显著性差异的 脂质代谢物。【结果】 缺血性中风患者（观察组）与健康人（对照组）存在差异的脂质代谢物，共鉴定出游离脂肪酸、神经酰胺、 鞘磷脂、心磷脂、卵磷脂等14个差异代谢物，其中有4个脂质代谢物表达下调，10个表达上调，差异均有统计学意义（P＜ 0.05）。【结论】 缺血性中风患者和健康人舌苔存在差异的脂质代谢物，这些差异的脂质代谢物有望成为缺血性中风的潜在生 物标志物。

Objective To explore the differences of lipid metabolites in tongue coating between ischemic stroke patients and healthy people， thus to screen out the potential biomarkers for tongue coating of ischemic stroke patients. Methods Twenty patients confirmed as ischemic stroke were selected as the observation group， and another 20 controls receiving healthy medical checkup at the same period were selected as the control group. All of them were aged between 40 and 80 years. Using ultra-high performance liquid chromatography-mass spectrometry （UHPLC-MS） technology，and by combined with the statistical methods of principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA），non-targeted lipid metabolomics study was performed on tongue coating samples of the observation group and the control group. According to the criteria that the VIP value in the orthogonal signal correction-based orthogonal partial least squares discriminant analysis （OPLS-DA） model was greater than 1 and the P value of the Wilcoxon rank test was less than 0.05，lipid metabolites with significant differences were screened and determined. Results Differential lipid metabolites exist in ischemic stroke patients （observation group） and healthy people （control group）， and a total of 14 lipid metabolites were identified，and they were free fatty acids，ceramide，sphingomyelin，cardiolipin，lecithin，etc. Of the 14 lipid metabolites，4 were down-regulated and 10 were up-regulated，and the differences were statistically significant （P＜0.05）. Conclusion There exist differential lipid metabolites in tongue coating of patients with ischemic stroke and the healthy controls， and these different lipid metabolites are expected to become potential biomarkers for ischemic stroke.

R277.7

广东省中医药局科研项目（编号：20241026）