目的 分析支气管肺发育不良（bronchopulmonary dysplasia, BPD）患儿在校正胎龄（postmenstrual age, PMA）36周的血清代谢组学改变，筛选其潜在生物标志物及相关代谢通路，并分析其与患儿近期呼吸结局的关系。 方法 采用回顾性病例对照研究，纳入2024年1—12月间郑州大学附属儿童医院收治的胎龄28~32周20例BPD患儿，以及20例胎龄、体重、性别匹配的非BPD早产儿，于PMA 36周进行血清非靶向代谢组学分析。 结果 共筛选出13种可区分BPD的潜在生物标志物（曲线下面积>0.75，P<0.05），其中对苯二甲酸、磷脂酰肌醇、富马酸及溶血磷脂酸等8种显著上调（差异倍数≥1.5）；7α-羟基-3-氧代-4-胆甾烯酸酯、磷脂酰胆碱等5种显著下调（差异倍数≤1/1.5）。通路分析显示，甘油磷脂代谢、苯丙氨酸代谢等5条通路与BPD发生相关。甘油磷脂代谢与胆汁酸代谢紊乱可能影响BPD患儿近期不良呼吸结局。 结论 该研究筛选出的13种显著差异代谢物有望成为诊断BPD的标志物；甘油磷脂代谢与BPD的发生和近期呼吸不良结局相关。

Objective To analyze the serum metabolomic changes of preterm infants with bronchopulmonary dysplasia (BPD) at postmenstrual age (PMA) 36 weeks, screen potential biomarkers and associated metabolic pathways, and assess their relationship with short-term respiratory outcomes. Methods A retrospective case-control study was conducted. Infants with gestational age 28-32 weeks admitted to the Children's Hospital Affiliated to Zhengzhou University from January to December 2024 were included. Twenty infants with BPD and 20 gestational age-, birth weight-, and sex-matched non-BPD preterm infants were included. Serum collected at PMA 36 weeks was subjected to untargeted metabolomics analysis, and associations with short-term respiratory outcomes were analyzed. Results Thirteen potential biomarkers distinguishing BPD were identified (area under the curve >0.75, P<0.05). Eight biomarkers—including terephthalic acid, phosphatidylinositol, fumarate, and lysophosphatidic acid—were significantly upregulated (FC≥1.5), while five biomarkers, such as 7α-hydroxy-3-oxo-4-cholestenoate ester and phosphatidylcholine, were significantly downregulated (FC≤1/1.5). Pathway analysis indicated five pathways associated with BPD, including glycerophospholipid metabolism and phenylalanine metabolism. Dysregulation of glycerophospholipid and bile acid metabolism may affect adverse short-term respiratory outcomes in infants with BPD. Conclusions The 13 significantly different metabolites may serve as biomarkers for the diagnosis of BPD. Glycerophospholipid metabolism is associated with the occurrence of BPD and with adverse short-term respiratory outcomes.