Tcm Syndromes Of Hypertension In Patients With Serum Proteomics Differentially Expressed

Background:Hypertension(Essential Hypertension,EH) is the most common cardiovascular diseases and a clinical syndrome which mainly manifested the systemic arterial pressure increased and hold 95 precent in EH patients.Meanwhile,EH is a risk fator which is closely related to coronary heart disease,stroke,congestive heart failure,renal dysfunction, as well as one of the main risk factor lead to death.The pathogenesis of EH is not clear,and may be related to hyperfunction of sympathetic, excessive activation of the renin-angiotensin-aldosterone system, abnormalities of sodium retention and sodium discharge system,vascular remodeling as well as damaged endothelial function.While Chinese medicine believes that the formation is a long-term process and caused by the interaction of various factors such as constitution,emotion,diet,work and rest and so on.The endogenous factors include the relative predominance of yin and yang;the relative decline of yin and yang; congenital defects;viscera deficient.And excessive psychentonia, disorder of the emotion and diet portability are common factors of onset. The basic pathogenesis lies in liver,spleen and kidney;imbalance of yin and yang;failure of transportation and transformation;inhibited flow of blood and fluid;stagnation of phlegm and dampness;unfavorable of meridians and collaterals;consumption of fluid and blood;deficiency of heart-nutriment;blood stasis;yin and yang deficiency;transverse flow into meridians;incubative pathogenic factors tend to move and change involved other organs and developed into chest oppression,stroke and syncope.However,for etiology,whether modern medicine or traditional medicine is not clear and TCM syndrome mix subjective ideas more or less.The emergence of proteomics play an important role in discussing the pathogenesis of EH,researching the material basis of TCM syndrome as well as enriching the TCM diagnostic methods.Objective:To analyze the differential expression of serum proteome in EH patients with different TCM syndrome,select the specific protein markers of different syndromes and further to find the objective indicators of TCM syndrome differentiation.ethods:EH patients were typed by syndrome differentiation and brought into 40 cases syndrome of damp-heat in liver and gallbladder (GDSR) and 40 cases hypertensive dampness(TSYS),19 cases yin deficiency with yang hyperactivity(YXYK) and randomly choose 39 cases healthy people with EH disease.All selected person were performed mass spectrometry for serum proteomics(matrix-assisted laser desorption ionization time of flight mass spectrometry MADLAI-TOF-MS) and further analysed the map,selected the data by using Proteinchip Software 3.2.0 &Biomarker Patterns tm Software.iscussion:1.179 differential protein peaks(p<0.05) were found by compared serum protein spectrum in EH patients with health,among them 20 kinds of protein expression were increased,while 159 kinds were decreased.After further selected,protein with molecular weight 4175.258m/z protein peaks showed a low level expression in EH patients.2.182 differential protein peaks(p<0.05) were found by compared serum protein spectrum in EH patients of GDSR with health,among them 23 kinds of protein expression were increased,while 159 kinds were decreased.3.168 differential protein peaks(p<0.05) were found by compared serum protein spectrum in EH patients of TSYS with health,among them 15 kinds of protein expression were increased,while 153 kinds were decreased.4.124 differential protein peaks(p<0.05) were found by compared serum protein spectrum in EH patients of YXYK with health,among them 7 kinds of protein expression were increased,while 117 kinds were decreased.5.46 differential protein peaks(p<0.05) were found by compared protein spectrum in GDSR with TSYS group,among them 14 kinds of protein expression were increased in GDSR group,while 32 kinds were decreased.6.72 differential protein peaks(p<0.05) were found by compared protein spectrum in GDSR with YXYK group,among them 26 kinds of protein expression were increased in GDSR group,while46 kinds were decreased.7.22 differential protein peaks(p<0.05) were found by compared protein spectrum in TSYS with YXYK group,among them 3 kinds of protein expression were increased in TSYS group,while 46 kinds were decreased.8.The best marker of GDSR was selected by BPS Software.The result showed that the training model set up by five protein peaks(2487.19, 9334.95,2238.14,6624.36,5903.54) can distinguish GDSR.The sensitivity of the model is 86.667 percent,specficity is 96.552 percent, false positive rate is 3.448 percent,False positive rate is 3.448 percent, False negative rate is 13.333 percent(Youden's index =83.219%)9.The best marker of TSYS was selected by BPS Software.The result showed that the training model set up by five protein peaks(3161.26, 7922.98,7555.76,8030.79,3936.31) can distinguish TSYS.The sensitivity of the model is 96.552 percent,specificity is 83.333 percent, false positive rate is 16.667 percent,False positive rate is 3.448 percent, False negative rate is 13.333 percent(Youden's index =79.885%)Conclusion:1.Protein or peptide,represented by differential protein peak between serum protein spectrum in EH patients and health.It is important to further isolate and identify for revealing the pathogenesis of EH. 2.Differential protein peak of serum protein spectrum in patients with different syndrome may be internal material basis of external manifestation of syndrome.It is hopeful to reveal the nature of TCM by identifmg the differential protein and determining its function.3.Screening the differential protein marker and establishing the syndrome model established the objective symbol for proteomics expression of GDSR and TSYS at the molecular level,also provide a more objective and reliable means for syndrome differentiation of GDSR syndrome and TSYS syndrome.