舒心饮对冠心病患者脂代谢及三磷酸腺苷结合盒转运体蛋白A1／G1表达的影响

Effects of Shuxinyin on lipid metabolism and expression of ATP-binding cassette transporter A1/G1 in patients with coronary heart disease

目的 探讨舒心饮对冠心病患者脂代谢及巨噬细胞三磷酸腺苷结合盒转运体蛋白A1/G1（ABCA1/ABCG1）表达的影响.方法 选取浙江嘉兴市中医医院2013年10月至2015年10月心内科门诊和住院的冠心病患者60例,按随机数字表法分为观察组及对照组,每组30例.两组均给予西药常规治疗,观察组在西药常规治疗基础上服用舒心饮（药物组成：黄芪30 g、党参15 g、麦冬15 g、生地黄9 g、熟地黄9 g、枸杞15g、桑寄生15g、葛根9 g）,对照组仅给予西药常规治疗,两组均连用14d.检测两组患者治疗前后总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）的变化及巨噬细胞ABCA1和ABCG1的mRNA和蛋白表达水平.结果 治疗后观察组TC、LDL-C水平均明显低于对照组[TC （mmol/L）：3.72±0.58比3.38±0.66,LDL-C（mmol/L）：2.39±0.68比2.05±0.59,均P＜0.05],HDL-C明显高于对照组（mmol/L：1.30±0.15比1.15±0.35,P＜0.05）.反转录-聚合酶链反应（RT-PCT）显示,观察组治疗后ABCA1和ABCG2的mRNA表达均高于对照组[ABCA1 mRNA （2-ΔΔCt）：1.05±0.12比0.92±0.16,ABCG1 mRNA（2-ΔΔCt）：0.95±0.11比0.89±0.08,均P＜0.05].蛋白质免疫印迹试验（Western Blot）显示,观察组治疗后ABCA1和ABCG1的蛋白表达高于对照组[ABCA1（灰度值）：0.48±0.09比0.64±0.17,ABCG1（灰度值）：0.37±0.21比0.61±0.12,均P＜0.05].结论 舒心饮可以影响冠心病患者的脂代谢,其机制可能与上调巨噬细胞ABCA1和ABCG1的表达有关.

Objective To investigate the effects of Shuxinyin on lipid metabolism and expression of ATP-binding cassette transporter （ABC） A1/G1 in macrophages of patients with coronary heart disease. Methods Sixty patients with coronary heart disease admitted to the Department of Cardiology including outpatients and inpatients in Zhejiang Jiaxing Hospital of Traditional Chinese Medicine （TCM） from October 2013 to October 2015 were enrolled, and they were divided into observation group and control group according to the random number table method, 30 patients in each group. The two groups were given routine treatment of western medicine. The patients in observation group besides routine western medicine treatment, they were additionally given Shuxinyin [ingreients： astragalus 30 g, eodonopsis pilosula 15 g, ophiopognn japonicus 15 g, rehmannia 9 g, prepared rehmannia 9 g, Chinese wolfberry 15 g, herba taxilii 15 g, pueraria 9 g], while in the control group, the patients only received the routine treatment of western medicine. After 14 days of continuing treatment, the changes of total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） and high density lipoprotein cholesterol （HDL-C）, as well as expressions of the ABCAI/ABCG1 mRNA and protein in macrnphages of patients were measured in the two groups, before and after treatment. Results After treatment, the levels of TC, LDL-C in the observation group were lowel^d significantly than those in control group （retool/L, TC was 3.72±0.58 vs. 3.38±0.66, LDL-C was 2.39±0.68 vs. 2.05±0.59, both P 〈 0.05）; HDL-C was obviously higher in observation group than that in control group （mmol/L： 1.30±0.15 vs. 1.15±0.35, P 〈 0.05）, Reverse-transcription polymerase chain reaction （RT-PCT） displayed： after treatment the expressions of ABCAI and ABCGI mRNA in the observation group were higher than those of the control group [ABCA1 （2-aact）： 1,05±0.12 vs. 0.92±0.16, ABCG1 （2-a act）： 0.95±0.11 vs. 0.89±0.08, both P 〈 0.05]; Western Blot displayed： after treatment the expressions of ABCA1 and ABCG1 protein in the observation group were higher than those in control group [ABCA1 （gray value）： 0.48±0.09 vs. 0.64±0.17, ABCG1 （gray value）： 0.37±0.21 vs. 0.61±0.12, all P 〈 0.05]. Conclusions Shuxinyin can affect lipid metabolism in patients with coronary heart disease, and its mechanism may be related to the up regulation of the expressions of ABCA 1 and ABCG 1 in macrophages.