冠心病心绞痛三种血瘀证的血浆代谢组学研究

Metabolomic Study on Plasma from Patients with Angina Pectoris Due to Coronary Heart Disease with Three Kinds of Blood-Stasis Syndrome

目的研究冠心病心绞痛血瘀证(气滞血瘀证、心血瘀阻证、气虚血瘀证)患者的血浆代谢组学变化。方法对18例健康人、18例冠心病心绞痛血瘀证患者(6例气滞血瘀证、6例心血瘀阻证、6例气虚血瘀证)的血浆样本进行氢核磁共振(1HNMR)检测。通过偏最小二乘判别分析(PLS-DA)方法研究各组之间的血浆代谢产物谱差异。结果各组血浆HNMR谱的PLS-DA结果显示,与健康人相比,心绞痛血瘀证患者血浆柠檬酸、1琥珀酸、葡萄糖、乙酰糖蛋白、低密度脂蛋白、极低密度脂蛋白、3-羟基丁酸、谷氨酸、脯氨酸、亮氨酸含量较高,高密度脂蛋白、不饱和脂肪酸、苏氨酸、组氨酸含量较低。气虚血瘀证组与其他两个血瘀证组差别较大,而气滞血瘀证与心血瘀阻证差别不明显。与其他血瘀证相比,气虚血瘀证组血浆柠檬酸、3-羟基丁酸、丙酮、氧化三甲胺含量较高,葡萄糖、N-乙酰糖蛋白、酪氨酸、苯丙氨酸、脯氨酸、亮氨酸含量较低。结论血浆HNMR代谢谱1差异能明显区分健康人与心绞痛血瘀证患者;不能区分心绞痛气滞血瘀证与心血瘀阻证;能在一定程度上区分气虚血瘀证与其他血瘀证。代谢组学方法对于研究冠心病心绞痛中医证候具有重要价值。

Objective To explore the plasma metabolomic profile of patients with angina pectoris due to coronary heart disease with blood-stasis syndrome.To examine potential application of metabolomic analysis in studies of Chinese Traditional Medicine syndromes of Angina Pectoris patients.Methods Eighteen patients of angina pectoris with blood-stasis syndrome（APBS） were classified into Qi-stagnation and blood-stasis syndrome（QSBS）,heart blood-stasis syndrome（HBS）,Qi-deficieney and blood-stasis syndrome（QDBS）.Eighteen healthy volunteers served as the controls.Their plasma metabolites were analyzed using Hydro-Nuclear Magnetic Resonance（1H NMR）spectrometer for the Partial Least Squares Discriminant Analysis（PLS-DA）.Results PLS-DA of plasma H NMR spectra revealed different 1 metabolic spectra between healthy people and APBS patients.Compared with healthy people,citrate,succinate,glucose,glycoprotein,LDL,VLDL,3-hydroxybutyrate,glutamine,proline,leucine increased in APBS patients,while HDL,unsaturated lipid,threonine,histidine decreased considerably.Different metabolic spectra also were revealed between QDBS patients and other APBS patients.Compared with QSBS patients and HBS patients,Citrate,3-hydroxybutyrate,acetone,TMAO increased in QDBS patients,while glucose,NAC,tyrosine,phenylalanine,proline,leucine decreased.Conclusion Metabolomic study is a feasible and promising way to detect the variation of plasma metabolomics of Angina Pectoris patients with different TCM Syndromes.