基于CaN-NFTA3信号通路探讨充血性心力衰竭常见中医证候物质基础  

Exploration on Material Basis of Common Chinese Medical Syndromes in Congestive Heart Failure Based on CaN-NFAT3 Pathway

作　　者：张蕾[1] 李小茜[2] 何建成[2] ZHANG Lei;LI Xiao-qian;HE Jian-cheng(Department of Integrated Traditional and Western Medicine,The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Henan,471003;Basic Medical College,Shanghai University of TCM,Shanghai,201203)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院中西医结合科,河南471003 [2]上海中医药大学基础医学院,上海201203

出　　处：《中国中西医结合杂志》2023年第5期542-548,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81803996)。

摘　　要：目的 研究充血性心力衰竭(CHF)气虚血瘀证、气阴两虚证、阳虚水泛证中钙调神经磷酸酶-活化T细胞核因子3(CaN-NFAT3)通路关键蛋白的表达变化及与临床指标的关联。方法 收集CHF气虚血瘀证、气阴两虚证、阳虚水泛证患者及健康对照者各30名,应用酶联免疫吸附法测定血清中CaN、NFAT3、GATA4蛋白含量。采用Pearson和Spearman统计学方法进行关联研究。结果 CHF患者CaN、NFAT3、GATA4蛋白表达水平高于健康人群(P<0.01)。与阳虚水泛证比较,气虚血瘀证、气阴两虚证患者CaN、NFAT3、GATA4蛋白含量降低(P<0.01)。CaN、NFAT3、GATA4蛋白含量与NYHA心功能分级呈正相关性(r=0.897,P=0.000;r=0.903,P=0.000;r=0.921,P=0.000),与B型脑钠肽(BNP)含量呈正相关性(r=0.851,P=0.000;r=0.853,P=0.000;r=0.789,P=0.000),与左室射血分数(LVEF)水平呈负相关性(r=-0.793,P=0.000;r=-0.803,P=0.000;r=-0.631,P=0.000)。CaN对CHF常见中医证候诊断价值较高,界值如下:气虚血瘀证为878.10 pg/mL,气阴两虚证为932.42 pg/mL,阳虚水泛证为1 080.36 pg/mL。结论 CaN-NFAT3通路关键蛋白含量变化可反映CHF病情及常见中医证候程度,反映CHF不同中医证候内在物质基础;CaN可作为辨别CHF常见中医证候的潜在标志物。Objective To explore the expression changes of key proteins in CaN-NFAT3 pathway of Qideficiency-blood-stasis syndrome,Qi-yin-deficiency syndrome and Yang-deficiency-water-overflowing syndrome in congestive heart failure(CHF)and its correlation with clinical indicators.Methods Thirty participants in each group of CHF with Qi-deficiency-blood-stasis syndrome,Qi-yin-deficiency syndrome and Yang-deficiency-wateroverflowing syndrome and healthy control subjects were recruited.The contents of CaN,NFAT3 and GATA4 in serum were determined by enzyme linked immunosorbent assay.The Pearson and Spearman method were used for statistical analysis.Results The protein expression levels of CaN,NFAT3 and GATA4 in CHF patients were higher than those in healthy participants(P<0.01).Compared with Yang-deficiency-water-overflowing syndrome,the protein contents of CaN,NFAT3 and GATA4 in the syndrome of Qi-deficiency-blood-stasis syndrome and Qi-yin-deficiency syndrome decreased(P<0.01).The protein contents of CaN,NFAT3 and GATA4 were positively correlated with NYHA cardiac function classification(r=0.897,P=0.000;r=0.903,P=0.000;r=0.921,P=0.000),was positively correlated with brain natriuretic peptide(BNP)content(r=0.851,P=0.000;r=0.853,P=0.000;r=0.789,P=0.000),was negatively correlated with left ventricular ejection fraction(LVEF)leve(l r=-0.793,P=0.000;r=-0.803,P=0.000;r=-0.631,P=0.000).The threshold value of CaN for common Chinese medical(CM)syndrome of CHF was as follows:878.10 pg/mL in Qi-deficiency-blood-stasis syndrome,932.42 pg/mL in Qiyin-deficiency syndrome,and 1080.36 pg/mL in Yang-deficiency-water-overflowing syndrome.Conclusions The changes of key protein content of CaN-NFAT3 pathway could reflect the severity of CHF disease with common CM syndroms and reflect the internal material basis of different CM syndroms of CHF.CaN can be used as a potential marker to distinguish common CM syndromes of CHF.

关 键 词：充血性心力衰竭 气虚血瘀证 气阴两虚证 阳虚水泛证 CaN-NFAT3通路 物质基础 中医 

分 类 号：R259[医药卫生—中西医结合]