冠心病合并房颤气虚血瘀证患者血浆神经递质相关性研究  

Study on Plasma Neurotransmitter Metabolism in Patients with Coronary Heart Disease and Atrial Fibrillation(Syndrome of Blood Stasis due to Qi Deficiency)

作　　者：杜宜航 段城林 魏艺[1] 朱雪萍 柴若宁 胡元会[1] Du Yihang;Duan Chenglin;Wei Yi;Zhu Xueping;Chai Ruoning;Hu Yuanhui(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中医急症》2025年第2期211-214,222,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：中央高水平中医医院临床研究和成果转化能力提升项目(HLCMHPP2023082);中央高水平中医医院临床研究和成果转化能力提升项目——传承名老中医药专家学术经验专项(HLCMHPP2023011)。

摘　　要：目的 筛选冠心病合并房颤(CHDAF)气虚血瘀证与非气虚血瘀证患者的差异神经递质,为CHDAF临床诊治以及气虚血瘀证的辨证论治提供生物学指标借鉴,丰富临床诊治的思路。方法 采用液相色谱质谱联用技术检测入组受试者的39种血浆神经递质的浓度和含量,分析冠心病合并房颤气虚血瘀证与非气虚血瘀证患者血浆神经递质代谢谱的差异。结果 气虚血瘀组合并脑卒中的概率更高。气虚血瘀组犬尿喹啉酸(KYNA)、色醇(TOL)、褪黑素(MT)、N-乙酰血清素(NAS)、肾上腺素(E)、变肾上腺素(ME)血浆含量升高;吲哚-3-甲醛(I3A)、色氨酸(Trp)、喹啉酸(QA)、精氨酸(Arg)、谷氨酰胺(Gln)、琥珀酸(SA)血浆含量降低;多元Logistic回归分析结果显示E、KYNA、NAS是CHDAF气虚血瘀证的影响因素。差异主要表现在Trp、MT、儿茶酚胺类物质代谢过程,推测可能与气虚血瘀证交感神经激活、能量代谢障碍、昼夜节律改变及肠道稳态失衡相关。结论冠心病房颤气虚血瘀证患者血浆神经递质代谢谱发生改变,差异主要表现在Trp、MT、儿茶酚胺类物质代谢过程,可能与气虚血瘀证交感神经激活、能量代谢障碍、昼夜节律改变及肠道稳态失衡相关。Objective:To identify differential neurotransmitters in patients with coronary heart disease and atri-al fibrillation(CHDAF)with syndrome of blood stasis due to qi deficiency to those without,to provide biological markers for the clinical diagnosis and treatment of CHDAF,as well as the differentiation and treatment principles for syndrome of blood stasis due to qi deficiency,thus enriching clinical approaches.Methods:Liquid chromatog-raphy-mass spectrometry was used to measure the concentration and content of 39 plasma neurotransmitters in en-rolled patients.The metabolic profiles of plasma neurotransmitters were analyzed between patients with syndrome of blood stasis due to qi deficiency and those without.Results:Patients with syndrome of blood stasis due to qi deficiency had a higher probability of stroke.The plasma levels of KYNA,TOL,MT,NAS,E,ME were elevated;while I3A,Trp,QA,Arg,Gln,SA were reduced in the syndrome of blood stasis due to qi deficiency group.Multi-variate logistic regression analysis showed that E,KYNA,and NAS were influencing factors for syndrome of blood stasis due to qi deficiency in CHDAF.The dfferences were mainly observed in the metabolic processes of trypto-phan,melatonin,and catecholamines,suggesting possible associations with sympathetic nerve activation,energy me-tabolism disorders,circadian rhythm changes,and gut homeostasis imbalance associated with syndrome of blood stasis due to qi deficiency.Conclusion:The metabolism of plasma neurotransmitters in CHDAF patients with syn-drome of blood stasis due to qi deficiency is altered,primarily in the metabolic processes of tryptophan,melatonin,and catecholamines,potentially linked to sympathetic nerve activation,energy metabolism disorders,circadian rhythm alterations,and gut homeostasis imbalance related to syndrome of blood stasis due to qi deficiency.

关 键 词：房颤 冠心病 气虚血瘀证 神经递质 

分 类 号：R541.4[医药卫生—心血管疾病]