Study On Iron Metabolism In Patients With Coronary Heart Disease And Blood Stasis Syndrome

Background:Coronary heart disease is the leading cause of death in cardiovascular patients.The basic pathological change of coronary heart disease is atherosclerosis of coronary arteries.Lipoproteins play an important role in the process of atherosclerosis(AS)by participating in lipid transport,exchange and lipid metabolism.The abnormal state of oxidative stress promotes the progression of AS.Ischemic modified albumin/serum albumin ratio(IMA/ALB ratio,IMAR)is widely used as an index to evaluate the level of oxidative stress and the severity of disease.Increased iron levels in the body will induce reactive oxygen species(ROS)to produce toxicity and cause damage to tissues and organs through the Fenton reaction.Different indicators of the body's metabolic level will play different roles in AS.Coronary heart disease belongs to the categories of "thoracic paralysis" and"heartache" in traditional Chinese medicine,and blood stasis syndrome accounts for a relatively high proportion of coronary heart disease in TCM syndrome research.Therefore,it is of great significance to deeply study and explore the role of iron metabolism in the occurrence and development of blood stasis syndrome of coronary heart disease.Objective:In this study,enzyme-linked immunosorbent assay(ELISA)was used to determine the expression levels of IMA,Hepcidin,HJV,and FPN,immunoturbidimetry was used to determine the expression levels of SF,TRF,and sTfR,and ferrousazine colorimetry was used to determine the expression levels of SI and TIBC.IMAR,compare the difference between the above indicators in patients with coronary heart disease and healthy people,patients with coronary heart disease and blood stasis syndrome and patients with coronary heart disease and non-blood stasis syndrome,and the relationship between body iron level and oxidative stress,and explore different indicators with coronary heart disease and coronary heart disease.The correlation of blood stasis syndrome provides a reference index for syndrome differentiation of coronary heart disease.Methods:Collected 130 patients with coronary heart disease hospitalized in Guanganmen Hospital of China Academy of Chinese Medical Sciences from October 2019 to February 2020,using 30 healthy people in the southern area of Guanganmen Hospital as controls during the same period,and according to the syndrome differentiation of Chinese medicine Divided into blood stasis syndrome group and non-blood stasis syndrome group.All enrolled patients took venous blood samples on an empty stomach on the day of admission or the next morning,and the expression levels of IMA,Hepcidin,HJV,and FPN were measured by ELISA,and the expression levels of SF,TRF,and sTfR were measured by immunoturbidimetry,To determine the expression levels of SI and TIBC,Calculate IMAR,and observed in patients with coronary heart disease and healthy people.The situation of the above indicators between blood stasis syndrome and non-blood stasis syndrome.Using SPSS25.0software analysis,measurement data are expressed as mean±standard deviation(x±s).The data conform to the normal distribution and t test is used;the data do not conform to the normal distribution and rank sum test is adopted.The classification data were tested by chi-square.Correlation analysis was performed using Spearman correlation.The influencing factors were analyzed by binary logistic regression analysis.Statistical significance was indicated by P<0.05.Results:A total of 130 patients with coronary heart disease and 30 healthy patients were included in this study.TCM syndrome differentiation was performed on patients with coronary heart disease.There were 80 patients with coronary heart disease and blood stasis syndrome;50 patients with coronary heart disease had non-blood stasis syndrome.According to statistical analysis,there was no significant difference in age,gender,blood glucose,liver and kidney function between patients with coronary heart disease and healthy group.There was no significant difference in age,gender,blood glucose,liver and kidney function between patients with coronary heart disease and blood stasis syndrome and patients with coronary heart disease without blood stasis syndrome.1.Results of Hepcidin,FPN,HJV,SF,SI,TIBC,TRF,sTfR,and IMA,IMAR expression levels in patients with coronary heart disease1.1 Results of Hepcidin,FPN,HJV,SF,SI,TIBC,TRF,sTfR expression levels in patients with coronary heart diseaseCompared with the serum test indicators of the two groups,compared with the healthy group,the levels of Hepcidin and SF in the coronary heart disease group increased(Hepcidin:0.23±0.14ng/ml VS 0.15±0.08ng/ml;SF:260.32±101.59ug/L VS 170.63±106.45ug/L;P<0.001);SI and TIBC increased(SI:19.41±5.44umon/L VS 15.85±3.77umon/L;TIBC:61.61±8.28umon/L VS 58.14±9.60umon/L;P<0.05).TRF and sTfR levels were reduced(TRF:212.12±36.95mg/dL VS 227.29±36.59mg/dL;sTfR:33.27±11.80nmol/L VS 39.27±14.32nmol/L;P<0.05).FPN and HJV levels increased(FPN:1.64±1.20ng/ml VS 1.30±0.84ng/ml;HJV:8.45±8.12ng/ml VS 7.56±5.72ng/ml;P>0.05).1.2 Results of IMA and IMAR expression levels in patients with coronary heart diseaseComparison of serum detection indicators between the two groups,compared with the healthy group:IMA levels in the coronary heart disease group increased(83.19±15.00U/ml VS 81.57±14.77U/ml,P>0.05);IMAR levels increased(2.05±0.27 VS 1.85±0.26,P<0.001)1.3 Spearman correlation analysis suggests that coronary heart disease is positively correlated with Hepcidin,SF,SI,TIBC,and IMAR,and negatively correlated with sTfR1.4 The binary logistic regression analysis showed that Hepcidin,SF,TIBC,and IMAR were closely related to coronary heart disease.2.Results of Hepcidin,FPN,HJV,SF,SI,TIBC,TRF,sTfR and IMA,IMAR expression levels in patients with coronary heart disease and blood stasis syndrome2.1 Hepcidin,FPN,HJV,SF,SI,TIBC,TRF,sTfR expression in patients with coronary heart disease and blood stasis syndromeComparison of serum detection indicators between the two groups,compared with the non-blood stasis syndrome group:the SF level in the blood stasis syndrome group was elevated(SF:260.32±01.59ug/L VS 170.63±106.45ug/L;P<0.001);Hepcidin,SI,TIBC level increased(Hepcidin:0.25±0.15ng/ml VS 0.20±0.10ng/ml;SI:20.13±5.08umon/L VS 18.25±5.84umon/L;TIBC:62.72±6.74umon/L VS 59.83±10.10 umon/L;P<0.05).TRF and sTfR levels decreased(TRF:206.79±36.85mg/dL VS 220.66±35.83mg/dL;sTfR:31.34±11.87nmol/L VS 36.36±11.12nmol/L;P<0.05).FPN level decreased(FPN:1.63±1.31ng/ml VS 1.67±1.02ng/ml;P>0.05);HJV level increased(HJV:8.58±8.05ng/ml VS 8.24±5.88ng/ml;P>0.05).2.2 Results of IMA and IMAR expression in patients with coronary heart disease and blood stasis syndromeComparison of serum test indicators between the two groups,compared with non-blood stasis syndrome group:IMA level in the coronary heart disease group increased(83.78±15.06U/ml VS82.24±15.00U/ml,P>0.05);IMAR level increased(2.10±0.31VS1.98±0.20,P<0.05).2.3 Spearman correlation analysis showed that coronary heart disease blood stasis syndrome was positively correlated with Hepcidin,SF,SI,TIBC,and IMAR,and negatively correlated with sTfR.Binary logistic regression analysis showed that Hepcidin,SF,and IMAR were closely related to blood stasis syndrome of coronary heart disease.Conclusion:1.The level of iron metabolism in patients with coronary heart disease increased,Hepcidin,SF,SI,TIBC increased,and the levels of TRF and sTfR decreased.2.Patients with coronary heart disease have increased levels of oxidative stress and IMAR levels.3.Patients with coronary heart disease and blood stasis syndrome had higher iron metabolism levels than non-blood stasis syndrome patients Hepcidin,SF,SI,TIBC increased,and TRF and sTfR levels decreased.4.Patients with coronary heart disease and blood stasis syndrome have higher levels of oxidative stress and IMAR than non-blood stasis syndrome patients.5.Coronary heart disease blood stasis syndrome group was positively correlated with Hepcidin,SF,SI,TIBC,IMAR,and negatively correlated with sTfR.