痰瘀证肿瘤患者血浆代谢组学研究

目的了解痰瘀证肿瘤患者血浆代谢组变化情况,探讨痰瘀证肿瘤患者体内代谢变化机理。方法对460例痰瘀证、非痰瘀证肿瘤患者和50名健康人血浆进行核磁共振氢谱检测,谱图积分结果用正交偏最小二乘判别分析法(OPLS-DA)进行分析。结果与健康人比较,痰瘀证肿瘤患者血浆中亮氨酸、丙氨酸、瓜氨酸、酪氨酸、组氨酸、精氨酸、蛋氨酸、异亮氨酸、缬氨酸、乙酰半胱氨酸等多种氨基酸显著下降(P<0.05),葡萄糖、糖蛋白、谷氨酰胺、鲨肌醇、乳酸、胆碱、肌酸也明显下降(P<0.05),但是痰瘀证肿瘤患者血浆中甲酸、丙酮、乙酸、乙酰乙酸、丙酮酸、β-羟丁酸、肉碱、丙二酸以及不饱和脂肪酸、极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇(LDL-C)等代谢物含量高(P<0.05)。与非痰瘀证肿瘤患者比较,痰瘀证肿瘤患者血浆亮氨酸、丙氨酸、瓜氨酸、酪氨酸、组氨酸、异亮氨酸、缬氨酸等多种氨基酸以及谷氨酰胺、肌醇、鲨肌醇、乳酸、肌酸等代谢物含量明显偏低(P<0.05),而痰瘀证肿瘤患者血浆中丙酮、乙酰乙酸、不饱和脂肪酸、VLDL-C、α-葡萄糖、β-葡萄糖、糖蛋白等代谢物含量比非痰瘀证肿瘤患者高,两组比较,差异有统计学意义(P<0.05)。结论痰瘀证肿瘤患者体内脂肪代谢加强,多种氨基酸下降,细胞抗氧化能力的下降导致细胞膜损伤加重,痰瘀证肿瘤患者体内代谢紊乱程度可能比非痰瘀证肿瘤患者严重。

英文摘要:

Objective To study metabonomic changes in plasma of tumor patients of phlegm-stasis syndrome by Chinese medicine and their in vivo metabolic mechanism.Methods 1H nuclear magnetic resonance(NMR) based metabonomic analysis was performed on plasma samples from 356 tumor patients of the phlegm-stasis syndrome and 104 tumor patients of the non-phlegm-stasis syndrome,and 50 healthy subjects.The spectrogram integral results were analyzed by orthogonal partial least-squares discriminant analysis(OPLS-DA).Results Compared with healthy subjects,various amino acids including leucine,alanine,citrulline,tyrosine,histidine,arginine,methionine,isoleucine,valine,acetylcysteine,etc.in the plasma of patients of the phlegm-stasis syndrome were significantly lowered(P<0.05).Glucose,glycoprotein,glutamine,myo-inositol,lactic acid,choline,creatine also significantly decreased(P<0.05).But the plasmal formic acid,acetone,acetic acid,acetoacetate,pyruvate,β-hydrocxy butyrate,carnitine,malonic acid,and unsaturated fatty acid,very low density lipoprotein cholesterol(VLDL-C),low density lipoprotein cholesterol(LDL-C) increased in tumor patients of the phlegm-stasis syndrome.Compared with tumor patients of non-phlegm-stasis syndrome,patients of the phlegm-stasis syndrome had obvious lower plasmal contents of leucine,alanine,citrulline,tyrosine,histidine,isoleucine,valine,glutamine,myo-inositol,scyllo-inositol,lactic acid,creatine(P<0.05),higher plasmal contents of acetone,acetoacetate,unsaturated fatty acid,VLDL-C,α-glucose,β-glucose,glycoprotein,and so on(P<0.05).Conclusions Tumor patients of the phlegm-stasis syndrome had strengthened in vivo fat metabolism and lowered various amino acids.The decreased antioxidation capacities resulted in aggravated cell membrane injuries.The in vivo metabolic disorder was more severe in tumor patients of the phlegm-stasis syndrome than in tumor patients of the non-phlgem-stasis syndrome.

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