慢性萎缩性胃炎脾胃湿热证和脾胃虚寒证患者的血浆代谢组学特征
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摘要
目的探讨慢性萎缩性胃炎脾胃虚寒证和脾胃湿热证患者血浆代谢组学特征。方法收集45例慢性萎缩性胃炎患者,其中脾胃湿热证28例,脾胃虚寒证17例,另选取40例健康志愿者为对照。收集各组受试者肘静脉血5 ml,运用核磁共振氢谱(1H-NMR)定量检测血浆代谢物含量,采用主成分分析法(PCA)、偏最小二乘-判别分析法(PLS-DA)及正交偏最小二乘-判别分析法(OPLS-DA)进行多元统计分析。结果筛选出潜在生物标志物11种,其中慢性萎缩性胃炎患者血浆中葡萄糖、丙氨酸、缬氨酸等含量高于健康人,而谷氨酸、甘氨酸、乳酸、甜菜碱等水平低于健康人。脾胃湿热证组患者缬氨酸、乳果糖水平高于脾胃虚寒证组,而异丁酸、甲酸、肌肽含量低于脾胃虚寒证组。结论慢性萎缩性胃炎脾胃虚寒证和脾胃湿热证患者存在较为明显的糖代谢、氨基酸分解代谢紊乱,且两种证型在糖代谢、脂代谢、氨基酸代谢、核酸代谢方面存在差异。
Objective To investigate the characteristics of plasma metabolomics in chronic atrophic gastritis(CAG) patients with spleen-stomach dampness-heat syndrome and spleen-stomach cold and deficiency syndrome.Methods A total of 45 cases of CAG were selected,with 28 cases of spleen-stomach dampness-heat syndrome and17 cases of spleen-stomach deficiency-cold syndrome,and 40 cases of healthy volunteers were selected as the normal group. There was 5 m L of venous blood that was collected from each group,and the contents of plasma metabolites were determined quantitatively by1 H-NMR,and the principal component analysis(PCA),partial least squares discriminant analysis(PLS-DA) and orthogonal partial least squares discriminant analysis(OPLS-DA) were used for multivariate statistical analysis. Results A total of 11 potential biomarkers were screened,among them,glucose,alanine,valine levels were higher in CAG patients than in healthy individuals,while glutamine,glycine,lactic acid and glycine betaine were significantly lower than those in healthy individuals. Valine and lactulose in patients with spleen-stomach dampness-heat syndrome were higher than those with spleen-stomach deficiency-cold syndrome,while isobutyric acid,formic acid and carnosine were lower than those with spleen-stomach deficiency-cold syndrome.Conclusion Chronic atrophic gastritis patients with spleen and stomach deficiency syndrome and spleen-stomach damp-heat syndrome have obvious disorders of glucose metabolism and amino acid catabolism,and there are differences in glucose metabolism,lipid metabolism,amino acid metabolism and nucleic acid metabolism between the two syndromes.
Objective To investigate the characteristics of plasma metabolomics in chronic atrophic gastritis(CAG) patients with spleen-stomach dampness-heat syndrome and spleen-stomach cold and deficiency syndrome.Methods A total of 45 cases of CAG were selected,with 28 cases of spleen-stomach dampness-heat syndrome and17 cases of spleen-stomach deficiency-cold syndrome,and 40 cases of healthy volunteers were selected as the normal group. There was 5 m L of venous blood that was collected from each group,and the contents of plasma metabolites were determined quantitatively by1 H-NMR,and the principal component analysis(PCA),partial least squares discriminant analysis(PLS-DA) and orthogonal partial least squares discriminant analysis(OPLS-DA) were used for multivariate statistical analysis. Results A total of 11 potential biomarkers were screened,among them,glucose,alanine,valine levels were higher in CAG patients than in healthy individuals,while glutamine,glycine,lactic acid and glycine betaine were significantly lower than those in healthy individuals. Valine and lactulose in patients with spleen-stomach dampness-heat syndrome were higher than those with spleen-stomach deficiency-cold syndrome,while isobutyric acid,formic acid and carnosine were lower than those with spleen-stomach deficiency-cold syndrome.Conclusion Chronic atrophic gastritis patients with spleen and stomach deficiency syndrome and spleen-stomach damp-heat syndrome have obvious disorders of glucose metabolism and amino acid catabolism,and there are differences in glucose metabolism,lipid metabolism,amino acid metabolism and nucleic acid metabolism between the two syndromes.
引文
[1]CORREA P. Human gastric carcinogenesis:a multistep and multifactorial process-First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention[J]. Cancer Res,1992,52(24):6735-6740.
[2]王喜军.中药药效物质基础研究的系统方法学:中医方证代谢组学[J].中国中药杂志,2015,40(1):13.
[3]中华医学会消化病学分会.中国慢性胃炎共识意见[J].中华消化杂志,2013,33(1):44-55.
[4]于中麟.慢性胃炎的内镜分型分级标准及治疗的试行意见[J].中华消化内镜杂志,2004,21(2):427-428.
[5]中华医学会消化病学分会.慢性胃炎的病理诊断标准[J].中华消化杂志,2007,27(1):49-50.
[6]张声生,李乾构,唐旭东,等.慢性萎缩性胃炎中医诊疗共识意见[J].中医杂志,2010,51(8):749-753.
[7]LI Z,LIU X,WANG J,et al. Analysis of urinary metabolomic profiling for unstable angina pectoris disease based on nuclear magnetic resonance spectroscopy[J]. Mol Biosyst,2015,11(12):3387-3396.
[8]李军祥,陈誩,吕宾,等.慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):121-131.
[9]王宁丁,刘晓秋,伍军军,等.补中益气丸对糖尿病大鼠胃黏膜诱导型一氧化氮合酶及环氧化酶2表达的影响[J].吉林中医药,2015,35(3):279-282.
[10]范衡.糖脂代谢紊乱与慢性萎缩性胃炎的相关性[D].乌鲁木齐:新疆医科大学,2016.
[11]简咏梅,李传荣,袁俊清,等.糖尿病与胃癌风险相关性队列研究的meta分析[J].中华内分泌代谢杂志,2014,30(10):839-843.
[12]冯日露,麻静.糖尿病胃轻瘫的发病机制、诊断和治疗研究进展[J].上海交通大学学报(医学版),2016,36(5):761-766.
[13]李雪英,杨丽霞,姜良恩,等.炎症因子在糖尿病肾病发病机制中的中西医研究述评[J].世界中西医结合杂志,2016,11(4):572-575.
[14]HUI S,GHERGUROVICH JM,MORSCHER RJ,et al.Glucose feeds the TCA cycle via circulating lactate[J].Nature,2017,551(7678):1-15.
[15]尹明明,施嫣红,沈蓉蓉,等.益生菌改善炎症性肠病患者的临床疗效和肠屏障功能观察[J].中国微生态学杂志,2017,29(4):427-430.
[16]王均衡,李英帅,骆斌,等.阳虚体质者粪便的代谢组学研究[J].北京中医药大学学报,2017,40(1):65-69.
[17]何丽清,盖江华,郭鑫.基于核磁共振的小青龙汤证大鼠肺组织的代谢组学研究[J].中华中医药杂志,2014,29(7):2338-2340.
[18]李岩,徐进康,陆喜荣.胃炎系列方治疗胃癌前病变的临床与病理研究[J].中国中西医结合杂志,2011,31(12):1635-1638.
[19]MARQUES C,MAURIZ JL,SIMONETTO D,et al.Glutamine prevents gastric oxidative stress in an animal model of portal hypertension gastropathy[J]. Ann Hepatol,2011,10(4):531-539.
[20]谷俊朝,马涛,王宇.甘氨酸保护作用机制与相关疾病探讨[J].北京医学,2005,27(9):560-563.
[21]黄红娜,张丹参,郑晓霞,等.甜菜碱药理作用的研究进展[J].医学综述,2009,15(24):3788-3789.
[22]王大伟,周荣斌,姚咏明.胆碱能抗炎通路在炎症反应中的作用[J].生理科学进展,2010,41(3):217-220.
[23]陈燕,曹郁生,刘晓华.短链脂肪酸与肠道菌群[J].江西科学,2006,24(1):38-40.
[24]LIM CC,FERGUSON LR,TANNOCK GW. Dietary fibres as “prebiotics”:implications for colorectal cancer[J]. Mol Nutr Food Res,2005,49(6):609-619.
[25]付肖岩,劳绍贤,黄志新,等.慢性腹泻脾胃湿热证与肠道菌群的关系[J].中国中西医结合消化杂志,2005,13(4):223-225.
[26]江来,万小健,卞金俊,等.重症胰腺炎大鼠血液的核磁共振谱代谢组学研究[J].上海医学,2009,32(11):999-1002.
[27]杨泽民,陈蔚文,王颖芳.慢性浅表性胃炎脾虚与脾胃湿热证患者物质能量代谢基因差异表达研究[J].中国中西医结合杂志,2012,32(9):1180-1187.
[2]王喜军.中药药效物质基础研究的系统方法学:中医方证代谢组学[J].中国中药杂志,2015,40(1):13.
[3]中华医学会消化病学分会.中国慢性胃炎共识意见[J].中华消化杂志,2013,33(1):44-55.
[4]于中麟.慢性胃炎的内镜分型分级标准及治疗的试行意见[J].中华消化内镜杂志,2004,21(2):427-428.
[5]中华医学会消化病学分会.慢性胃炎的病理诊断标准[J].中华消化杂志,2007,27(1):49-50.
[6]张声生,李乾构,唐旭东,等.慢性萎缩性胃炎中医诊疗共识意见[J].中医杂志,2010,51(8):749-753.
[7]LI Z,LIU X,WANG J,et al. Analysis of urinary metabolomic profiling for unstable angina pectoris disease based on nuclear magnetic resonance spectroscopy[J]. Mol Biosyst,2015,11(12):3387-3396.
[8]李军祥,陈誩,吕宾,等.慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):121-131.
[9]王宁丁,刘晓秋,伍军军,等.补中益气丸对糖尿病大鼠胃黏膜诱导型一氧化氮合酶及环氧化酶2表达的影响[J].吉林中医药,2015,35(3):279-282.
[10]范衡.糖脂代谢紊乱与慢性萎缩性胃炎的相关性[D].乌鲁木齐:新疆医科大学,2016.
[11]简咏梅,李传荣,袁俊清,等.糖尿病与胃癌风险相关性队列研究的meta分析[J].中华内分泌代谢杂志,2014,30(10):839-843.
[12]冯日露,麻静.糖尿病胃轻瘫的发病机制、诊断和治疗研究进展[J].上海交通大学学报(医学版),2016,36(5):761-766.
[13]李雪英,杨丽霞,姜良恩,等.炎症因子在糖尿病肾病发病机制中的中西医研究述评[J].世界中西医结合杂志,2016,11(4):572-575.
[14]HUI S,GHERGUROVICH JM,MORSCHER RJ,et al.Glucose feeds the TCA cycle via circulating lactate[J].Nature,2017,551(7678):1-15.
[15]尹明明,施嫣红,沈蓉蓉,等.益生菌改善炎症性肠病患者的临床疗效和肠屏障功能观察[J].中国微生态学杂志,2017,29(4):427-430.
[16]王均衡,李英帅,骆斌,等.阳虚体质者粪便的代谢组学研究[J].北京中医药大学学报,2017,40(1):65-69.
[17]何丽清,盖江华,郭鑫.基于核磁共振的小青龙汤证大鼠肺组织的代谢组学研究[J].中华中医药杂志,2014,29(7):2338-2340.
[18]李岩,徐进康,陆喜荣.胃炎系列方治疗胃癌前病变的临床与病理研究[J].中国中西医结合杂志,2011,31(12):1635-1638.
[19]MARQUES C,MAURIZ JL,SIMONETTO D,et al.Glutamine prevents gastric oxidative stress in an animal model of portal hypertension gastropathy[J]. Ann Hepatol,2011,10(4):531-539.
[20]谷俊朝,马涛,王宇.甘氨酸保护作用机制与相关疾病探讨[J].北京医学,2005,27(9):560-563.
[21]黄红娜,张丹参,郑晓霞,等.甜菜碱药理作用的研究进展[J].医学综述,2009,15(24):3788-3789.
[22]王大伟,周荣斌,姚咏明.胆碱能抗炎通路在炎症反应中的作用[J].生理科学进展,2010,41(3):217-220.
[23]陈燕,曹郁生,刘晓华.短链脂肪酸与肠道菌群[J].江西科学,2006,24(1):38-40.
[24]LIM CC,FERGUSON LR,TANNOCK GW. Dietary fibres as “prebiotics”:implications for colorectal cancer[J]. Mol Nutr Food Res,2005,49(6):609-619.
[25]付肖岩,劳绍贤,黄志新,等.慢性腹泻脾胃湿热证与肠道菌群的关系[J].中国中西医结合消化杂志,2005,13(4):223-225.
[26]江来,万小健,卞金俊,等.重症胰腺炎大鼠血液的核磁共振谱代谢组学研究[J].上海医学,2009,32(11):999-1002.
[27]杨泽民,陈蔚文,王颖芳.慢性浅表性胃炎脾虚与脾胃湿热证患者物质能量代谢基因差异表达研究[J].中国中西医结合杂志,2012,32(9):1180-1187.
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