心衰心阳虚证血浆氨基酸(缬、苯丙、异亮、亮氨酸)代谢指纹图谱研究

Study on the fingerprints of plasma amino acids(Val, Phenylalanine, Isoleucine, Leucine) of patients with xin-yang deficiency of heart failure

目的:探讨应用高效液相色谱(HPLC)的方法研究心衰心阳虚证患者血浆中氨基酸(缬、苯丙、异亮、亮氨酸)的代谢指纹图谱,为心衰心阳虚证患者的中医证候量化研究提供客观数据支持。方法:纳入研究患者心衰40例,非心衰27例,用HPLC法得出受试者血浆氨基酸(缬、苯丙、异亮、亮氨酸)的代谢指纹图谱,寻找心衰组与非心衰组代谢图谱指标的相关性,以及各组的氨基酸代谢指纹图谱指标、BNP与Boston积分、心阳虚中医证候积分的相关性。结果:心阳虚中医证候积分随B型尿钠肽(BNP)水平增加而增加的且呈线性相关(P<0.001);心阳虚证积分与缬氨酸、亮氨酸、异亮氨酸浓度变化没有明显趋势关系,与苯丙氨酸呈正相关趋势,构成线性关系(P<0.05)。结论:应用HPLC测定氨基酸的代谢指纹图谱,具有选择性高、分析速度快和灵敏度高等优点,4种氨基酸中苯丙氨酸与心阳虚证候积分存在明确的直线关系;在此研究基础上,氨基酸代谢指纹图谱有望可用于找出心衰心阳虚患者的证候特点。

Objective： Discussion on the application of high performance liquid chromatography （HPLC） to study the metabolic fingerprinting of amino acid （Val, Phe, Ile, Leu） in the plasma of patients with xin-yang defciency of heart failure, in order to provide data support for the quantitative study of syndromes in TCM, especially the patients with xin-yang deficiency of heart failure. Methods： In the study of patients with heart failure in 40 cases, non-heart failure in 27 cases, the application of HPLC were used to get the metabolic fingerprinting of amino acid （Val, Phe, Ile, Leu） in the plasma of patients, and analyze dependency between the two groups, as well as the relation in the B-type natriuretic peptide （BNP） and the Boston integral, and the heart yang deficiency syndrome integral. Results： The heart yang deficiency syndrome integral showed a linear correlation with the BNP level, the BNP level increased with the increasing of heart yang deficiency syndrome （P〈0.001）; There is no obvious trend between the heart yang deficiency syndrome integral and Val, Ile, Leu, while the positive linear trend with Phe （P〈0.05）. Conclusion： Using the application of HPLC to test the metabolic fingerprint of amina acids has several advantages, such as high selectivity, fast analysis speed and high sensitivity. And there is clear linear relationship between Phe and the heart yang deficiency syndrome integral in the four amino acids; On this basis, amino acid metabolic fingerprint is expected to find out the characteristics of syndrome of deficiency of heart yang in patients with heart failure.