The Initial Observing The Peripheral Blood Monocytes Surface Of Toll Like Receptor-4Expression And The Correlated Indexes In H-type Hypertension Of Yin Deficiency And Yang Hyperactivity Syndrome And Excessive Accumulation Of Phlegm-dampness Syndrome

Objective:Clinical preliminary observations on Toll like receptor4(TLR-4) expression on peripheral blood monocytes(PBMCs) in patients with H-type hypertension(EH)[i.e. accompanied by with hyperhomocysteinemia(hyperhomocysteinemic) hypertension],who were diagnosed and typed in traditional Chinese medicine(TCM)syndrome into Yin deficiency and Yang hyperactivity and excessive accumulation of Phlegm-dampness,to analyse positive rate correlation of expression of TLR-4positive rate,homocysteine(Hcy) levels and laboratory parameters,comparing between the two groups,so as to initially explore to contribute to the objective targets which can be used to distinguish the syndromes of hypertension,and to guide the clinical treatment.Methods:1.Designing clinical observation form,fill in precisely included in the study of patients with clinical materials;2.Choosing H-type hypertension,with the Yin deficiency and Yang hyperactivity syndrome of21cases,21cases of Phlegm-dampness syndrome included in the study,in the cardiovascular outpatient and hospitalization in the3rd affiliated hospital of Nanjing University of Traditional Chinese Medicine(Nanjing Chinese Medicine Hospital);3.Detecting homocysteine,toll-like receptor4(TLR-4),the fasting plasma glucose(FPG),serum total cholesterol(TC), triglyeride(TG),the low density lipoprotein cholesterol(LDL-C),the high density lipoprotein-cholestol(HDL-C) and the uric acid(UA) between two groups of patients;4.Using the SPSS17.0statistics software to compare the positive rate of the PBMCs surface of TLR-4,and Hey levels in Yin deficiency and Yang hyperactivity syndrome and excessive accumulation of Phlegm-dampness syndrome of H-type hypertension,as well as correlation with laboratory indexes.Results:1.The positive rate of the PBMCs surface of TLR-4in excessive accumulation of H-type hypertension was significantly higher than that in Yin deficiency and Yang hyperactivity syndrome[(57.66±34.57)vs(35.30±37.29),P=0.006,P<0.05];2.The plasma Hey levels in Yin deficiency and Yang hyperactivity syndrome of H-type hypertension is with a considerable that in excessive accumulation of Phlegm-dampness syndrome of H-type hypertension;3.In Phlegm-dampness syndrome of H-type hypertension group,TLR-4positive expression rate positively correlated with FPG;4.In Yin deficiency and Yang hyperactivity syndrome group,TLR-4positive expression rate positively correlated with TC;5.In Phlegm-dampness syndrome of hypertension group,the plasma Hey levels negatively correlated with TC,TG,LDL-C and HDL-C. Conclusion:The issue of clinical preliminary observations:1.The positive rate of the PBMCs surface of TLR-4in excessive accumulation of H-type hypertension was significantly higher than that in Yin deficiency and Yang hyperactivity syndrome;2.The plasma Hey levels in Yin deficiency and Yang hyperactivity syndrome of H-type hypertension is with a considerable that in excessive accumulation of Phlegm-dampness syndrome of H-type hypertension;3.In Phlegm-dampness syndrome of H-type hypertension group,TLR-4positive expression rate has a certain correlation with FPG,and in Yin deficiency and Yang hyperactivity syndrome of H-type hypertension group,TLR-4positive expression rate has a certain correlation with FPG and TC;4.The plasma Hey levels has a certain correlation with diastolic blood pressure(DBP),FPG,TC,TG,LDL-C and HDL-C in Phlegm-dampness syndrome of hypertension group,and DBP,FPG and UA have a certain correlation with the plasma Hey levels in Yin deficiency and Yang hyperactivity syndrome of hypertension;5.The TLR-4positive expression rate in two groups of H-type EH patients may be associated with target organ damage(TOD),blood pressure levels,glucose and lipid metabolism,uric acid,and other indicators have some correlations.However,the clinical observation of this essay,sample size is much less,it needs to further expand the sample size.Whether the peripheral blood mononuclear cell surface of TLR-4positive expression rate in H-type hypertensive patients could be as an indicator of detecting and evaluating the early H-type hypertensive patients with TOD,and played the role of early warning of cardiovascular and cerebrovascular diseases is worth further study.