高密度脂蛋白在不同证型冠心病患者血清中的表达及意义
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摘要
目的探讨血清高密度脂蛋白(HDL)抗炎抗氧化功能与冠心病脾虚证的相关性。方法选择60例确诊为稳定型冠心病的患者进行中医辨证分型,分为脾(气)虚组和非脾虚组,所有病例均进行血清脂蛋白谱(SLPG)、对氧磷酶-1(PON1)、髓过氧化物酶(MPO)、超敏C反应蛋白(hs-CRP)及白细胞介素6(IL-6)水平的检测。结果与冠心病非脾虚患者比较冠心病脾虚患者HDL在SLPG中异常率表达增高(P<0.01),HDL_3含量明显下降,HDL_5含量明显升高,MPO、hs-CRP及IL-6水平明显升高(P<0.01)而冠心病脾虚患者PON1水平明显下降(P<0.01)。结论血清HDL亚组分表达异常与中医脾虚证有一定的相关性,冠心病脾虚患者HDL亚组分发生失功能改变可能主要表现为HDL抗氧化能力减弱,促炎作用增强,HDL抗炎抗氧化功能与其亚组分HDL_3、HDL_5关系密切,深入研究脾虚与HDL抗炎抗氧化功能的关系,可望为研发改善HDL功能的中药新药和防治冠心病提供线索。
Objective To investigate the correlation of the anti- inflammatory and antioxidant actions of high-density lipoprotein( HDL) subclasses with Pi- deficiency syndrome in coronary heart disease( CHD) patients. Methods Sixty patients with a confirmed diagnosis of stable CHD were selected for TCM syndrome typing into the Pi- deficiency( PD) group and non- Pi- deficiency( NPD) group. Serum lipoprotein electrophoretogram( SLPG),paraoxonase- 1( PON1),myeloperoxidase( MPO),hypersensitive C reactive protein( hs- CRP) and interleukin 6( IL- 6) were measured in all patients. Results SLPG abnormality rate of HDL,MPO,hs- CRP,IL- 6 and HDL5 levels were higher in the CHD PD group than in the CHD NPD group( P < 0. 01). Compared with CHD NPD group,levels of PON1,HDL3 declined significantly( P < 0. 01). Conclusions Abnormal expression of serum HDL and its sub- components is correlated with TCM PD syndrome type. The loss- of- function change of HDL subclasses in CHD PD patient shows reduced antioxidant and anti- inflammatory actions. The anti- inflammatory and antioxidant functions of HDL are closely related to its subclasses HDL3 and HDL5. Therefore,further investigation of the correlation of Pi- deficiency syndrome in TCM with anti- inflammatory and antioxidant functions of HDL may hopefully provide clues for developing new medications in TCM to improve HDL function for CHD prevention and treatment.
Objective To investigate the correlation of the anti- inflammatory and antioxidant actions of high-density lipoprotein( HDL) subclasses with Pi- deficiency syndrome in coronary heart disease( CHD) patients. Methods Sixty patients with a confirmed diagnosis of stable CHD were selected for TCM syndrome typing into the Pi- deficiency( PD) group and non- Pi- deficiency( NPD) group. Serum lipoprotein electrophoretogram( SLPG),paraoxonase- 1( PON1),myeloperoxidase( MPO),hypersensitive C reactive protein( hs- CRP) and interleukin 6( IL- 6) were measured in all patients. Results SLPG abnormality rate of HDL,MPO,hs- CRP,IL- 6 and HDL5 levels were higher in the CHD PD group than in the CHD NPD group( P < 0. 01). Compared with CHD NPD group,levels of PON1,HDL3 declined significantly( P < 0. 01). Conclusions Abnormal expression of serum HDL and its sub- components is correlated with TCM PD syndrome type. The loss- of- function change of HDL subclasses in CHD PD patient shows reduced antioxidant and anti- inflammatory actions. The anti- inflammatory and antioxidant functions of HDL are closely related to its subclasses HDL3 and HDL5. Therefore,further investigation of the correlation of Pi- deficiency syndrome in TCM with anti- inflammatory and antioxidant functions of HDL may hopefully provide clues for developing new medications in TCM to improve HDL function for CHD prevention and treatment.
引文
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[3]中国中医研究院西苑医院.赵锡武医疗经验/现代著名老中医名著重刊丛书[M].北京:人民卫生出版社,2005:12-15.
[4]吴焕林,徐丹苹,罗文杰,等.邓铁涛调脾护心法治疗冠心病心绞痛方案抗心肌缺血作用的临床队列研究[J].辽宁中医杂志,2012,39(3):385-387.
[5]LIANG D H,CHEN U Q,LI Z L,et al.Study on the relationship between serum high density lipoprotein and pi-deficiency syndrome in patients with coronary heart disease[J].Chin J Integr Med,2007,13(2):125-127.
[6]中国中西医结合学会心血管病专业委员会.冠心病中医辨证标准[J].中西医结合杂志,1991,11(5):257.
[7]张暋,李小敏,尹炳生,等.双梯度聚丙烯酰胺凝胶电泳对血清脂蛋白分离的初步观察[J].第一军医大学学报,1993,13(S2):535.
[8]张暋,李小敏,尹炳生.改良双梯度聚丙烯酰胺凝胶电泳及其应用的初步探讨[J].解放军医学杂志,1994,19(1):25.
[9]SHEKHANAWAR M,SHEKHANAWAR S M,KRISNASWAMY D,et al.The role of'paraoxonase-1 activity'as an antioxidant in coronary artery diseases[J].J Clin Diagn Res,2013,7(7):1284-1287.
[10]ESSAWY S S,ABO ELMATTY D M,GHAZY N M,et al.Antioxidant and anti-inflammatory effects of Marrubium alysson extracts in high cholesterol-fed rabbits[J].Saudi Pharm J,2014,22(5):472-482.
[11]WEBER C,NOELS H.Atherosclerosis:current pathogenesis and therapeutic options[J].Nat Med,2011,17(11):1410-1422.
[12]UDEANU M,GUIZZARDI G,DI PASQUALE G,et al.Relationship between coronary artery disease and C-reactive protein levels in NSTEMI patients with renal dysfunction:a retrospective study[J].BMC Nephrol,2014,15:152.
[13]GIGANTE B,STRAWBRIDGE R J,VELASQUEZ I M,et al.Analysis of the role of interleukin 6 receptor haplotypes in the regulation of circulating levels of inflammatory biomarkers and risk of coronary heart disease[J].PLo S One,2015,10(3):e0119980.
[14]吴鹏,梁东辉,刘映峰,等.血清高密度脂蛋白亚类1对人单核源性巨噬细胞泡沫化的影响[J].中华心血管病杂志,2009,37(2):156-160.
[15]张暋,陈允钦.血清脂蛋白动态平衡的探讨[J].第一军医大学学报,1999,19(4):12-15.