丹红注射液对不稳定型心绞痛患者围手术期代谢组学的影响

Effects of Danhong Injection on Perioperative Metabolomics in Patients with Unstable Angina Pectoris

目的:观察丹红注射液对不稳定型心绞痛(Unstable Angina Pectoris,UA)血瘀证患者择期经皮冠状动脉介入治疗(Percutaneous CoronaryIntervention,PCI)围手术期血清代谢组学的影响。方法:采用前瞻性、随机、对照、单盲的临床研究方法,选取2018年7月至2019年1月首都医科大学附属北京中医医院行PCI的中医证属血瘀证的UA患者61例作为研究对象,采用随机数字表法随机分为丹红组(n=31)和对照组(n=30)。丹红组采用西医规范治疗+丹红注射液治疗,对照组采用西医规范治疗+生理盐水,纳入健康志愿者10例。应用非靶向代谢组学方法对丹红组、对照组治疗前、PCI术后5 d及健康志愿者血清代谢产物进行分析。结果:治疗前,丹红组与对照组血清代谢产物谱比较,差异无统计学意义(P>0.05);治疗前,丹红组及对照组与健康组有较大的差异,差异代谢物包括甘油磷脂代谢、鞘脂代谢、嘌呤代谢、氨基酸代谢等代谢通路中相关代谢产物;PCI术后5 d,丹红组与对照组患者的血清代谢物谱均趋向健康组,与治疗前比较差异有统计学意义(P<0.05);术后丹红组患者的血清代谢物谱较对照组更接近健康组水平,差异有统计学意义(P<0.05)。结论:在西医规范治疗基础上使用丹红注射液,可使患者血清代谢产物水平更接近健康人群。

Objective:To observe the effects of Danhong Injection on perioperative serum metabonomics in patients with blood stasis syndrome of unstable angina pectoris(UA)by using percutaneous coronary intervention(PCI)in a certain period.Methods:A prospective,randomized,controlled,single blind clinical trial was conducted.A total of 61 UA patients with TCM blood stasis syndrome undergoing elective PCI were selected as the research objects and were randomly divided into a Danhong group(n=31)and a control group(n=30),and 10 healthy volunteers were included as baseline.Danhong group received Western medicine+DHI treatment,the control group received Western medicine+saline.Non-targeted metabolomics methods were used to analyze the serum metabolites of Danhong group,and control group before treatment,5 days after PCI and serum metabolites of healthy volunteers.Results:Before treatment,there was no significant difference in serum metabolites between the Danhong group and the control group.Before treatment,there was significant difference among the above 2 groups and the healthy group.Differential metabolites mainly included glycerophospholipid,sphingolipid,purine,and amino acid groups,which were generated in their metabolic pathways.After 5 days of PCI,the profiles of serum metabolites were significantly closer to the healthy group.Compared with before treatment,there was a statistical difference;the serum metabolite profile of patients in the Danhong group was closer to the level of the healthy group than the control group,and the difference was statistically significant.Conclusion:The use of Danhong Injection on the basis of Western medicine standard treatment can make the patient′s serum metabolite level closer to healthy people.