基于代谢组学分析肾虚督寒型强直性脊柱炎代谢网络特点  

Analysis of the Characteristics of the Metabolic Network in Ankylosing Spondylitis Patients with the Syndrome of Deficiency of Kidney and Cold of Governor Vessel by Metabolomics Methods

作　　者：梁伟东 彭剑虹 尹晓霞 叶雪英 陈少敬 LIANG Wei-Dong;PENG Jian-Hong;YIN Xiao-Xia;YE Xue-Ying;CHEN Shao-Jing(Dept.of Rheumatology,Dongguan Traditional Chinese Medicine Hospital,Dongguan 523200 Guangdong,China)

机构地区：[1]东莞市中医院风湿科,广东东莞523200

出　　处：《广州中医药大学学报》2021年第6期1124-1132,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科技专项资金资助项目(编号:20194013)。

摘　　要：【目的】通过检测肾虚督寒型强直性脊柱炎(AS)患者血清代谢谱,结合证候研究及炎症指标,探讨肾虚督寒型是否与患者内在代谢网络变化存在联系,为中医证候现代化研究提供科学依据和物质基础。【方法】选取25例肾虚督寒型AS患者作为AS组,另选取25例健康受试者作为对照组(健康组)。运用核磁共振氢谱(1H-NMR)技术,结合模式识别、多元统计等方法,分析AS组与健康组血浆中代谢物差异,配合分析2组受试者的中医证候分布情况及血沉(ESR)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)等各项炎症指标的不同,阐述肾虚督寒型AS的代谢特征和病理机制。【结果】(1)中医证候分布方面,AS组的腰痛、晨僵等主症及恶寒怕冷、四肢不温、梦中流涎、大便不调等次症的分布频率均明显高于健康组,差异均有统计学意义(P<0.05或P<0.01)。(2)炎症指标方面,AS组的CRP、ESR、IL-6和TNF-α水平均明显高于健康组,差异均有统计学意义(P<0.05)。(3)基于代谢组学技术,共筛选出19个代谢产物,涉及酪氨酸通路、甘氨酸-苏氨酸代谢通路、苯丙氨酸通路、酮体通路、β-丙氨酸通路、丙酮酸通路、氨酰tRNA生物合成、乙醛酸和二元酸通路等8条代谢通路。【结论】肾虚督寒型AS的病理机制可能与患者的能量代谢、氨基酸代谢、脂类代谢以及胃肠道菌群和免疫紊乱等代谢异常有关,其从多方面影响脾-肾功能轴而发为本病。Objective To investigate the possible relationship of syndrome of deficiency of kidney and cold of governor vessel with the changes of internal metabolic network of ankylosing spondylitis(AS)patients by examining the serum metabolic profile, exploring the distribution of syndrome manifestations, and detecting the inflammatory indicator levels, so as to supply scientific evidence and material basis for the research of modernization of traditional Chinese medicine(TCM)syndromes. Methods Twenty-five AS patients with the syndrome of deficiency of kidney and cold of governor vessel served as the AS group, and 25 healthy volunteers served as the control group. By using 1H nuclear magnetic resonance(1H-NMR)technique and by combining with the methods of pattern recognition and multivariate statistical analysis,we analyzed the differences of plasma metabolites in AS group and control group,investigated the distribution of TCM syndrome manifestations in the two groups, and detected the levels of inflammatory indicators of erythrocyte sedimentation rate(ESR), Creactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor alpha(TNF-α),so as to clarify the metabolic characteristics and pathogenesis of AS patients with the syndrome of deficiency of kidney and cold of governor vessel. Results(1)In respect of TCM syndrome manifestations in AS patients with the syndrome of deficiency of kidney and cold of governor vessel,AS group had higher occurrence rates of the primary symptoms of lumbago and morning stiffness,and higher occurrence rates of the secondary symptoms such as aversion to cold,cold limbs, slobbering at the night and abnormal stool than the control group, and the differences were statistically significant(P<0.05 or P<0.01).(2)In respect of the inflammatory indicators,AS group had higher levels of CRP,ESR,IL-6 and TNF-α than the control group,and the differences were statistically significant(P<0.05).(3)Based on metabolomics analysis,we screened out 19 metabolites,which involved 8 metabolic pathways of tyrosin

关 键 词：强直性脊柱炎 肾虚督寒型 核磁图谱(1H-NMR) 病理机制 脾-肾功能轴 

分 类 号：R259.932[医药卫生—中西医结合]