目的 研究慢性肾脏病患者的不同中医辨证分型与血清基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、同型半胱氨酸(Homocysteine,Hcy)、人附睾蛋白4(Human epididymal protein 4,HE4)等血清指标及血脂异常发生情况的关系.方法 选取2022年1月-2023年1月期间凉山州第二人民医院收治95例慢性肾脏病患者,中医辨证分型有肺肾气虚证39例、气阴两虚证17例、脾肾气虚证17例、脾肾阳虚证11例、肝肾阴虚证11例.检测比较慢性肾脏病组不同中医辨证分型患者的基线资料[包括性别、年龄、体质量指数(Body mass index,BMI)、病程]及血清 MMP-9、Hcy、HE4、白细胞介素-6(Interleukin-6,IL-6)、瘦素(Leptin,Lep)、血肌酐(Serum creati-nine,Scr)、尿素氮(Blood urea nitrogen,BUN)、尿酸(Uric acid,UA)水平,统计不同中医辨证分型患者血脂异常发生率,采用Spearman秩相关分析检验慢性肾脏病中医辨证分型与MMP-9、Hcy、HE4、IL-6、Leptin水平的相关性.结果 不同中医辨证分型患者在性别、年龄、BMI、病程、Hey、HE4方面组间比较,差异无统计学意义(P＞0.05).不同中医辨证分型患者MMP-9水平比较:肺肾气虚证组、气阴两虚证组＞脾肾气虚证组、脾肾阳虚证组、肝肾阴虚证组,差异有统计学意义(P＜0.05).MMP-9水平与肺肾气虚证、气阴两虚证呈正相关关系,差异有统计学意义(P＜0.05).不同中医辨证分型患者血清Scr、BUN水平组间比较,差异无统计学意义(P＞0.05);不同中医辨证分型患者血清IL-6水平比较,脾肾气虚证组、脾肾阳虚证组＞肺肾气虚证组、气阴两虚证组、肝肾阴虚证组,差异有统计学意义(P＜0.05);不同中医辨证分型患者血清Leptin水平比较,气阴两虚证组、肝肾阴虚证组＞肺肾气虚证组、脾肾气虚证组、脾肾阳虚证组,差异有统计学意义(P＜0.05);不同中医辨证分型患者血尿酸水平比较,肝肾阴虚证组＜肺肾气虚证组、气阴两虚证组、脾肾气虚证组、脾肾阳虚证组,差异有统计学意义(P＜0.05);气阴两虚证组血脂异常发生率高于肺肾气虚证(P＜0.05);经相关性分析,慢性肾脏病不同中医辨证分型与MMP-9、Hcy、HE4、IL-6、Leptin水平呈正相关,差异有统计学意义(P＜0.05).结论 MMP-9水平在肺肾气虚证、气阴两虚证中呈高表达,血清IL-6在脾肾气虚证、脾肾阳虚证中呈高表达,血清Leptin在气阴两虚证、肝肾阴虚证中呈高表达,血尿酸在肝肾阴虚证中呈低表达,并且不同证型患者血脂异常发生率存在一定差异,临床可对以上指标进行关注,对慢性肾脏病患者辨证分型进行评估.
Correlation Analysis of Different TCM Syndrome Differentiation Types of Chronic Kidney Disease with Expression of Serum Indexes and Dyslipidemia
Objective To study the relationships of different TCM syndrome differentiation types of chronic kid-ney disease with serum matrix metalloproteinase-9(MMP-9),homocysteine(Hcy),human epididymis protein 4(HE4),and dyslipidemia in the patients.Methods From January 2022 to January 2023,95 patients with chronic kidney disease were treated in The Second People's Hospital of Liangshan Yi Autonomous Prefecture.There were 39 cases with lung-kid-ney qi deficiency syndrome,17 cases with qi and yin deficiency syndrome,17 cases with spleen-kidney qi deficiency syndrome,11 cases with spleen-kidney yang deficiency syndrome,and 11 cases with liver-kidney yin deficiency syndrome.Baseline data(including gender,age,body mass index(BMI),and course of disease)and serum MMP-9,Hcy,HE4,interleukin-6(IL-6),leptin(Lep),creatinine(Scr),blood urea nitrogen(BUN),and uric acid(UA)levels of patients with different TCM syndrome differentiation types in the chronic kidney disease group were detected and compared.The incidence of dys-lipidemia in patients with different TCM syndrome differentiation types was analyzed.Spearman rank correlation analysis was used to examine the correlation between TCM syndrome differentiation types of chronic kidney disease and the levels of MMP-9,Hcy,HE4,IL-6,and Lep.Results There were no differences in gender,age,BMI,course of disease,Hcy,and HE4 among different TCM syndrome differentiation types(P＞0.05).The MMP-9 levels in patients with different TCM syndrome differentiation types were in descending order of lung-kidney qi deficiency syndrome group and qi and yin defi-ciency syndrome group＞spleen-kidney qi deficiency syndrome group,spleen-kidney yang deficiency syndrome group,and liver-kidney yin deficiency syndrome group(P＜0.05).The MMP-9 level was positively correlated with lung-kid-ney qi deficiency syndrome and qi and yin deficiency syndrome(P＜0.05).There were no differences in serum Scr and BUN levels among patients with different TCM syndrome differentiation types(P＞0.05).The serum IL-6 levels of pa-tients with different TCM syndrome differentiation types were compared,and the following order was observed:spleen-kid-ney qi deficiency syndrome group and spleen-kidney yang deficiency syndrome group＞lung-kidney qi deficiency syn-drome group,qi and yin deficiency syndrome group,and liver-kidney yin deficiency syndrome group(P＜0.05).The ser-um Lep levels of patients with different TCM syndrome differentiation types were compared,which were in the following or-der:qi and yin deficiency syndrome group and liver-kidney yin deficiency syndrome group＞lung-kidney qi deficiency syndrome group,spleen-kidney qi deficiency syndrome group,and spleen-kidney yang deficiency syndrome group(P＜0.05).The blood UA levels of patients with different TCM syndrome differentiation types were compared,following the or-der of liver-kidney yin deficiency syndrome grouP＜lung-kidney qi deficiency syndrome group,qi and yin deficiency syndrome group,spleen-kidney qi deficiency syndrome group,and spleen-kidney yang deficiency syndrome group(P＜0.05).Correlation analysis showed that different TCM syndrome differentiation types of chronic kidney disease were posi-tively correlated with the levels of MMP-9,Hcy,HE4,IL-6,and Lep(P＜0.05).Conclusion MMP-9 level is highly expressed in lung-kidney qi deficiency syndrome and qi and yin deficiency syndrome.Serum IL-6 is highly expressed in spleen-kidney qi deficiency syndrome and spleen-kidney yang deficiency syndrome.Serum Lep is highly expressed in qi and yin deficiency syndrome and liver-kidney yin deficiency syndrome.Blood UA has low expression in liver-kidney yin deficiency syndrome.Additionally,the incidence of dyslipidemia varies among patients with different TCM syndrome differ-entiation types.Clinical attention can be paid to the above indicators to evaluate the TCM syndrome differentiation types of patients with chronic kidney disease.
Chronic Kidney DiseaseMatrix Metalloproteinase-9HomocysteineHuman Epididymis Protein 4TCM Syndrome Differentiation Types
万方数据
维普
