| Objective: Study the factors related to lipid metabolism and plasma metabolites in the characteristic population of acute cerebral infarction patients,and apply the ancient and modern medical record cloud platform to analyze the medication patterns of the characteristic population of cerebral infarction,extract core prescriptions,and intervene in cerebral ischemia model rats to clarify their protective effects on ischemic stroke and explore their regulatory effects on blood lipid levels,aiming to provide new research ideas for the prevention and treatment of acute cerebral infarction.Method: Clinical section: To explore the occupancy of probands in 380 patients with acute cerebral infarction,we selected the most occupied probands as a characteristic population,used logistic regression analysis to explore their lipid metabolism levels,and used metabolomics technology,to analyze the plasma metabolites of,The medication situation of the characteristic population with 105 acute cerebral infarction was summarized,and with the help of the ancient case cloud platform system,the application characteristics of agents and traditional Chinese medicine in cases were statistically analyzed,and the medication laws of the characteristic population in the acute phase of cerebral infarction were summarized.Experimental section: Forty SD healthy male rats(SPF grade)were selected and divided into four groups by a random method,which specifically included the following: sham operated group,MCAO(phlegm dampness + blood stasis syndrome)group,MCAO(phlegm dampness + blood stasis syndrome)+ high-frequency drug group,and MCAO(phlegm dampness + blood stasis syndrome)+ positive drug atorvastatin group with10 rats in each group.Except for the sham group,rats in each group were prepared phlegm dampness + blood stasis syndrome model,and the cerebral ischemia model was prepared by wire thrombosis method.Only the vessels without plug were exposed in the sham group.Neurological deficits were assessed according to the zea-longa5 scoring scale.The cerebral infarct size was observed by 2% TTC staining.The protein content of NF-κB、 IL-8 and p38-MAPK in the brain of rats in each group was determined by Western bolt assay;And the levels of lipid metabolism of rats in each group were detected by using the blood lipid 4-item kit.Results: 1.Among patients with acute cerebral infarction,the proportion of patients with internal wind + phlegm dampness+blood stasis syndrome is the highest,which is a characteristic population,accounting for 27.63% of the total.The results of logistic regression analysis showed that for every 1 unit increase in TC,the probability of patients being the characteristic population increased by 2.240 times.For every 1 unit increase in LDL-C,the risk of becoming a characteristic population increases by1.446 times.For every 1 unit increase in body mass index,the probability of the patient belonging to the characteristic population increases by 1.015 times.For every1 unit increase in Apo B/Apo AI,the risk of becoming a characteristic population increases by 2.58 times.2.The metabolomics results showed that there were significant differences in plasma metabolites such as hydroxyproline and Biliverdin between patients with acute cerebral infarction(characteristic population)and healthy control group,while there were significant differences in plasma metabolites such as 1,2-dioleoyl-sn-glycero-3-photoshatidylcholine and Anserine between characteristic and non characteristic populations.The pathological mechanism of metabonomics changes in patients with acute cerebral infarction(characteristic population)may be related to steroid hormone biosynthesis signal pathway,endothelial cell signal transduction pathway,biotin metabolism pathway,vitamin digestion and absorption pathway,histidine metabolism pathway,ATP-binding cassette transporter and other pathways.3.The high-frequency drugs for the characteristic population in the acute stage of cerebral infarction are Poria cocos,ginger,jujube,tangerine peel,Pinellia ternata,Atractylodes macrocephala,Gastrodia elata,roasted licorice,ground beetle beetle,leech,etc.The results of animal experiments showed that except for the sham surgery group,which had normal neural function,all other three groups showed varying degrees of nerve damage.The model group had the largest area of cerebral infarction,while the traditional Chinese medicine group and atorvastatin group had relatively smaller areas.Compared with the sham surgery group,the modeling group showed an increase in TC,TG,LDL-C,and a decrease in HDL-C.After treatment with traditional Chinese medicine,TC,TG,LDL-C decreased,and HDL-C increased.Conclusions: 1.Among the patients with acute cerebral infarction,the proportion of patients whose syndrome elements were internal wind + phlegm dampness + blood stasis syndrome was the largest,TC,HDL-C,Apo B / Apo AI,BMI were the risk factors of the characteristic population in the acute phase of cerebral infarction.2.Hydroxyproline,biliverdin,1,2-dioleoyl-sn-glycero-3-phosphatidylcholine,anserine can be used as a marker of poor metabolism in the group of patients diagnosed with acute cerebral infarction(characteristic population),and the pathological mechanism may involve steroid hormone biosynthesis signaling pathway,endothelial cell signaling pathway,biotin metabolism pathway,vitamin digestion and absorption pathway,histidine metabolism pathway,ABC transporters and other pathways related.3.The core drugs used in the characteristic population with acute cerebral infarction are Banxia Baizhu Tianma Decoction + tu-tuina,leeches,and animal experimental studies have shown that this formula has an improvement in the neurological impairment and lipid metabolism levels of MCAO(phlegm dampness + blood stasis syndrome)rats. |
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