骨痿不同中医证型中血瘀与PPARγ、Runx2相关性研究

Study on the correlation between blood stasis and PPARγ and Runx2 in different TCM syndrome types of flaccidity of bones

目的 探讨骨痿不同证型中血瘀与PPARγ、Runx2的相关性。方法 94例符合要求的患者经辨证后分组,于入院第二天采集晨起空腹外周静脉血,检测凝血酶原时间(prothrombin time, PT)、活化部分凝血活酶时间(activated partial thromboplatin time, APTT)、凝血酶时间(thrombin time, TT)、纤维蛋白原(fipinogen, Fbg)及D-二聚体(D-Dimer,D-D),留取并采用Western blot检测入院第三天行全髋关节置换术股骨颈髓腔开路的松质骨中PPARγ、Runx2的蛋白表达量。结果 共94例患者符合纳入标准,分别为39例肝肾阴虚型、30例脾肾阳虚型、25例气滞血瘀型。3种证型骨痿患者的血清PT、TT、Fbg水平相比,差异无统计学意义(P>0.05)。气滞血瘀型骨痿患者较肝肾阴虚型及脾肾阳虚型骨痿患者在血清APTT及D-D水平方面有较大差异,差异有统计学意义(P<0.05)。气滞血瘀型骨痿患者松质骨PPARγ表达较肝肾阴虚型及脾肾阳虚型骨痿患者具有较高水平,差异有统计学意义(P<0.05)。脾肾阳虚型及气滞血瘀型骨痿患者松质骨Runx2表达较肝肾阴虚型骨痿患者具有较高水平,差异有统计学意义(P<0.05)。气滞血瘀型骨痿患者较脾肾阳虚型骨痿患者在松质骨Runx2表达方面有较大差异,差异有统计学意义(P<0.05)。结论 气滞血瘀型骨痿患者的PPARγ及Runx2蛋白水平相比其他两种证型患者的PPARγ及Runx2蛋白水平差异有统计学意义。

Objective To investigate the correlation between blood stasis and PPARγ and Runx2 in different syndrome types of flaccidity of bones. Methods Ninety-four eligible patients were divided into two groups after syndrome differentiation. Fasting peripheral venous blood was collected on the second day after admission. Prothrombin time(PT) and activated partial thromboplatin time(APTT), thrombin time(TT), fipinogen(Fbg), and D-dimer(DD) were detected. The protein expression levels of PPARγ and Runx2 in cancellous bone of open femoral neck cavity during total hip arthroplasty on the third day of admission were measured using Western blotting. Results A total of 94 patients met the inclusion criteria, including 39 patients with liver-kidney Yin deficiency, 30 patients with spleen-kidney Yang deficiency, and 25 patients with qi stagnation and blood stasis. There were no significant differences in serum PT, TT, and Fbg levels among the three syndrome types(P>0.05). Compared with patients with liver-kidney Yin deficiency and patients with spleen-kidney Yang deficiency, there were significant differences in serum APTT and DD levels between patients with qi stagnation and blood-stasis of flaccidity of bones(P<0.05). The expression of PPARγ in cancellous bone of patients with qi stagnation and blood stasis of flaccidity of bones was higher than that of patients with liver-kidney Yin deficiency and spleen-kidney Yang deficiency, and the difference was statistically significant(P<0.05). The expression of Runx2 in cancellous bone of patients with spleen-kidney-yang deficiency and qi stagnation and blood stasis of flaccidity of bones was higher than that of patients with liver-kidney-Yin deficiency(P<0.05). The expression of Runx2 in cancellous bone of patients with qi stagnation and blood stasis of flaccidity of bones was significantly different from that of patients with spleen-kidney Yang deficiency(P<0.05). Conclusion PPARγ and Runx2 protein levels in qi-stagnation and blood-stasis patients with flaccidity of bones are significantly different from those in other two types of syndrome.