| Multiple system atrophy(MSA)is a progressive degenerative disease of the central nervous system.Its pathogenesis and cause are not clear.At present,it is generally believed that the pathogenesis is related to the abnormal accumulation of ?-synucelin(?-syn)in oligodendrocytes and neurons of the central nervous system.Currently,the diagnosis of MSA mainly depends on clinical symptoms,and the diagnosis needs to be confirmed by autopsy pathology,so it is difficult to carry out scientific and effective laboratory examination before death.In recent years,it has been found that a large number of ?-syn is expressed in erythrocytes,and it is significantly up-regulated compared with normal subjects.In terms of traditional Chinese medicine,it is generally believed that MSA has the syndrome characteristics of'Dominated by imagination,but also empirical syndrome'.Our team's previous research results suggest that blood stasis,phlegm-dampness,kidney-qi deficiency,kidney-yang deficiency and kidney-yin deficiency are the main syndrome factors in patients with MSA.Therefore,our team put forward the hypothesis for the first time that abnormal aggregation of ?-syn is the specific manifestation of pathological products such as phlegm-dampness and blood stasis.By further exploring the TCM syndrome characteristics of MSA,the content of hemoglobin-binding ?-synuclein(Hb-?-syn)in peripheral blood erythrocytes of patients with MSA was determined,and the relationship between them was analyzed to verify the previous hypothesis.And to study the difference of Hb-?-syn in red blood cells between MSA patients and healthy people,to verify whether it can be used as a potential biological marker of MSA patients,hoping to provide new ideas for the diagnosis and treatment of MSA in traditional Chinese and western medicine in the future.Objective:?to further explore the TCM syndrome characteristics of MSA on the basis of previous research.?to compare the content of Hb-?-syn in peripheral blood erythrocytes of MSA patients with that of healthy people,and to explore the possibility of it as a peripheral biological marker of MSA.?to explore the correlation between MSA TCM syndrome and erythrocyte Hb-?-syn,and verify the early hypothesis.Methods:The patients were collected from February 2017 to October 2019 in the East of Beijing University of traditional Chinese Medicine.149 MSA patients in the Department of Encephalopathy of Fang Hospital and healthy subjects matched in sex and age(from Xuanwu Hospital of Capital Medical University)served as the control group.MSA patients completed the relevant scale(TCM syndrome score scale,UMSARS scale,etc.).After signing the informed consent form,the whole blood of 10 ml was taken,and the level of Hb-?-syn in erythrocytes was detected by ELISA method.The data were sorted out by EXCEL software and analyzed by SPSS23.0 statistical software.Results:(1)A total of 143 patients completed the information collection of TCM syndrome score scale.?Distribution of kidney deficiency main syndrome:94 patients with kidney qi deficiency syndrome(65.7%),33 patients with kidney yang deficiency(23.1%),13 patients with kidney yin deficiency(9.1%),3 patients with non-kidney deficiency(2.1%).Among the patients with kidney deficiency syndrome,89(63.6%)reached the level of level 2(obvious)of kidney deficiency syndrome.?Distribution of phlegm and blood stasis syndrome:there were 56 cases(37.6%)of phlegm-dampness syndrome and 54 cases(36.2%)of blood stasis syndrome,of which 32 cases(21.5%)had both phlegm and blood stasis.The overall score of kidney deficiency syndrome in patients with type ? Type-P was significantly higher than that in patients with type-C(P<0.05),but there was no significant difference between the scores of phlegm and blood stasis(P>0.05).(2)the detection of Hb-?-syn was completed in all patients,with a maximum of 351740.00 ng/ml,a minimum of 97792.94 ng/ml,and a median of 185500.00 ng/ml.P25 is 148016.41 ng/ml,and P75 is 226165.00 ng/ml.The content of Hb-?-syn in erythrocytes in patients with MSA was significantly higher than that in the control group(P<0.001).Hb in patients with MSA was significantly lower than that in healthy controls(P<0.001).The content of Hb-?-syn/Hb in patients with MSA was significantly higher than that in the control group(P<0.001).However,there was no significant correlation between Hb-?-syn and the age of onset,the age of seeing a doctor,the course of disease,the severity of the disease and the diagnostic type.(3)there was no significant correlation between the score of TCM syndrome of MSA and the level of Hb-?-syn.Conclusion:The main TCM syndromes of MSA are kidney deficiency syndrome(kidney qi deficiency syndrome,kidney yin deficiency syndrome and kidney yang deficiency syndrome),which can be accompanied by phlegm and blood stasis to a certain extent,and the contents of Hb-a-syn and Hb in erythrocytes of MSA patients are significantly abnormal than those of healthy people.Hb-?-syn and its ratio to Hb as the diagnostic standard of MSA has high sensitivity and specificity and is expected to become a new biological marker of MSA.The correlation between TCM syndromes and the level of Hb-?-syn in patients with MSA needs to be further explored. |
PDF Full Text Request