不同证型冠心病患者的血浆代谢组学研究

Metabolomic Study on Coronary Heart Disease Patients with Differen Chinese Medicine Pattern

目的运用代谢组学方法研究冠心病不同证型的代谢差异。方法收集痰阻心脉证、气阴两虚证、气滞血瘀证冠心病患者各10例,另收集健康人10例(正常组),各组受试者早上空腹采集血浆标本,应用超高效液色谱/串联四级杆-飞行时间质谱技术,分析冠心病不同证候及正常组血浆中的内源性小分子代谢物,从质谱中可以得到潜在生物标记物的精确分子量,并对潜在的生物标记物进行鉴定,探索冠心病不同证候的潜在代谢组学标志物。结果与正常组相比,冠心病组磷脂代谢、脂肪酸代谢、氨基酸代谢紊乱以及其导致的血小板聚集明显。葡萄糖、花生四烯酸、亚油酸在气滞血瘀证组中显著增高;气阴两虚证组苯丙氨酸、甘氨酸、高丝氨酸、葡萄糖、磷酸肌酸含量较低;痰阻心脉证组的葡萄糖含量比气滞血瘀证组高。结论葡萄糖、花生四烯酸、亚油酸、苯丙氨酸、甘氨酸、高丝氨酸、葡萄糖、磷酸肌酸等代谢产物与能量代谢、脂质代谢、糖代谢、氨基酸代谢紊乱密切相关,有望成为冠心病中医辨证分型的基础物质。

Objective To research the metabolic differences between different patterns of coronary heart disease （CHD） by metabolomics method. Methods Ten CHD patients with phlegm obstructing the heart vessels pattern, qi-yin deficiency pattern and qi stagnation blood stasis pattern were collected respectively and 10 healthy persons were collected as the normal group. The fasting plasma samples of subjects were collected in the morning. The ultra-high performance liquid chromatography/ quadrupole-time of flight tandem mass spectrometer was used to analyze the endogenous small molecule metabolites in plasma samples of CHD patients with different patterns and healthy persons. The precise molecular weight of potential biomarkers could be obtained from the mass spectrum. The potential biomarkers were identified to explore the potential metabolomics markers of CHD patients with different patterns. Results Comparing with the normal group, a disorder of phospholipid metabolism, fatty acid metabolism and amino acid metabolism occurred in the CHD group and led to platelet aggregation significantly. The contents of glucose, arachidonic acid and linoleic acid were significantly increased in the qi stagnation blood stasis pattern group. The contents of phenylalanine, glycine, homoserine, glucose and phosphocreatine were low in the qbyin deficiency pattern group. The glucose content in the phlegm obstructing the heart vessels pattern group was higher than that in the qi stagnation blood stasis pattern group. Conclusion The metabolites such as glucose, arachidonic acid, linoleic acid, phenylalanine, glycine, homoserine and creatine phosphate are closely related to the energy metabolism, lipid metabolism, glucose metabolism and amino acid metabolism. It is expected to become the material basis for TCM pattern identification of CHD.