基于核磁共振氢谱膝关节骨性关节炎 肝肾亏虚证血清代谢组学研究.docVIP

基于核磁共振氢谱膝关节骨性关节炎 肝肾亏虚证血清代谢组学研究 　　摘要：目的 研究膝关节骨性关节炎（KOA）肝肾亏虚证的内源性代谢物，探讨KOA肝肾亏虚证辨证的物质代谢轮廓。方法 选取KOA肝肾亏虚证和非肝肾亏虚证患者各50例及20例健康志愿者，空腹8 h后收集血清5 mL，采集核磁共振氢谱（1H-NMR），采用主成分分析法和偏最小二乘法判别分析的模式识别分析法进行多元统计分析。结果 1H-NMR能识别的代谢物23种，KOA患者与健康志愿者比较差异有统计学意义（P0.05，P0.01）。KOA肝肾亏虚证患者软骨基质代谢、能量代谢、脂类代谢、疼痛及炎症相关的代谢物与非肝肾亏虚证组比较差异有统计学意义（P0.05）。结论 KOA肝肾亏虚证患者有独特的1H-NMR代谢轮廓，KOA辨证分型具有代谢物质基础。 　　关键词：代谢组学；核磁共振氢谱；膝关节骨性关节炎；肝肾亏虚 　　DOI：10.3969/j.issn.1005-5304.2017.06.007 　　中图分类号：R274.94 文献标识码：A 文章编号：1005-5304（2017）06-0027-05 　　Abstract： Objective To study the endogenous metabolites of liver-kidney deficiency syndrome in knee-joint osteoarthritis （KOA） and explore the metabolic profile of KOA liver-kidney deficiency syndrome. Methods Totally 50 cases of KOA with liver-kidney deficiency syndrome and 50 cases of KOA with non-liver-kidney deficiency syndrome were collected respectively， and 20 cases of healthy volunteers were collected as the normal group. The serum samples of subjects were collected after fasting for 8 h. Hydro-Nuclear Magnetic Resonance （1H-NMR） spectrometer was collected. Principal component analysis and partial least squares discrimination analysis were used to conduct multivariate statistical analysis. Results 1H-NMR could identify 23 kinds of metabolites， and there was statistical significance between KOA patients and healthy volunteers （P0.05， P0.01）. There was statistical significance in cartilage matrix metabolism， energy metabolism， lipid metabolism， pain， inflammation-related metabolites in patients with KOA liver-kidney deficiency syndrome and patients with KOA non-liver-kidney deficiency syndrome （P0.05）. Conclusion Patients with KOA liver-kidney deficiency syndrome have a unique 1H-NMR metabolic profile， KOA syndrome has a metabolic material basis. 　　Key words： metabolomics； 1H-NMR； knee-joint osteoarthritis； liver-kidney deficiency 　　膝关节骨性关节炎（knee-joint osteoarthritis，KOA）是一种以进行性膝关节软骨变性、破坏及骨质增生为特征的中老年人的常?病和多发病，是引起膝关节疼痛甚至病残的常见原因，严重影响患者的生活质量和自理能力[1]。KOA属中医学“痹证”“骨痹” 　　等范畴，中医治疗K