肠道菌群及其代谢产物氧化三甲胺与冠心病相关性的中西医研究进展

Research Progress on the Relationship between Intestinal Microflora and Its Metabolites TMAO and Coronary Heart Disease

冠状动脉粥样硬化性心脏病,临床上也称为冠心病,是一种发生率较高的心血管疾病类型,且年轻化趋势明显。从以往的临床实践结果来看,冠心病的常见影响因素包括吸烟、高血压病、糖尿病、高脂血症等。肠道菌群代谢产物氧化三甲胺(TMAO)也是近年来研究证实的一种冠心病影响因素。TMAO可以提升人体的巨噬细胞清道夫受体水平,进而增强血浆胆固醇以及炎症细胞因子的表达,这也是导致细胞热休克蛋白含量升高的原因,直接增加人体的冠心病发生风险,并持续诱发疾病的恶化。针对这一情况,医学领域更加倾向于结合TMAO检查结果开展冠心病的预防和治疗。不同的肠道菌群结构,对三甲胺(TMA)与相应的转化途径加以调节,有利于TMAO水平的抑制,最终起到抑制冠心病的作用。笔者从中医和西医2个维度,对肠道菌群及其代谢产物TMAO与冠心病的关系及相关技术方法的研究进展进行了论述分析。

Coronary atherosclerotic heart disease,also known as coronary heart disease(CHD),is a type of cardiovascular disease with a high incidence,and the trend of younger people is obvious.According to the results of previous clinical practice,the common influencing factors of CHD include smoking,hypertension,diabetes,hyperlipidemia and so on.Trimethylamine oxide(TMAO),a metabolite of intestinal flora,has also been confirmed as an influential factor of coronary heart disease in recent years.TMAO can increase the level of macrophage scavenger receptor in the body,thereby enhancing the expression of plasma cholesterol and inflammatory cytokines,which are also responsible for the increase of cellular heat shock protein content,and directly increase the risk of coronary heart disease in the body and continuously induce disease deterioration.In view of this situation,the medical field is more inclined to carry out the prevention and treatment of coronary heart disease combined with the results of TMAO examination.According to different intestinal flora structure,the regulation of trimethylamine(TMA)and the corresponding transformation pathway is conducive to the inhibition of TMAO level,and ultimately plays a role in the inhibition of coronary heart disease.From two dimensions of traditional Chinese medicine and Western medicine,the author discussed and analyzed the relationship between intestinal microflora,its metabolite TMAO and coronary heart disease and the research progress of related technologies and methods.