论著

基于DRG分析临床路径管理对住院费用的影响

DRG-based analysis of the impacts on inpatient costs incurred clinical pathway management

:74-77
 
目的 运用DRG分析临床路径管理对患者住院费用的影响。方法 采用BJ-DRGs分组器,选取2016年广州某三级综合医院的出院患者病案首页信息及DRG分组信息,对比是否实施临床路径管理对患者的总体住院费用影响及各DRG组的住院费用差异。结果 路径组中位住院费用为9 239.41元,低于对照组的12 358.06元,差异有统计学意义(P<0.001)。费用构成分析发现,路径组的治疗费、检查费、药品费、手术费和其他费低于对照组,而材料费用相对较高。比较的14个DRG组中,6个DRG组的路径组住院费用低于对照组。结论 实行临床路径管理可降低患者住院费用、改变费用构成。结合DRG积极推进临床路径精细化管理,可有效控制病种成本,遏制医疗费用的不合理增长。
Objective Using DRG to analyze the impacts on inpatient costs of a hospital in Guangzhou as incurred by clinical pathway management. Methods As performed by BJ-DRGs, we selected DRG grouping information and medical record homepage information of the inpatients discharged from a tertiary hospital in Guangzhou in 2016. Then we compared the impacts of clinical pathway management on overall inpatients costs and the difference of inpatient costs for the DRG group. Results The median of inpatient costs in the clinical pathway group was 9239.41 yuan, was lower than that of control group which was 12358.06 yuan, and the difference was statistical difference (P<0.001). Cost composition analysis found that the costs of treatment, examination, medicine, surgery and the others in the clinical pathway group were much lower than that of the control group, while the cost of materials was relatively high. Among the 14 DRG group study, there were 6 DRG groups which the inpatient costs of the clinical path group was obviously lower than the control group. Conclusion The implementation of clinical pathway management may reduce the inpatient costs and change the makeup of costs. Therefore, combining with DRG, we actively promote the refined management of clinical pathway, which may effectively control the costs of diseases and the unreasonable growth of medical expenses.
论著

盾叶冠心宁片与复方丹参滴丸治疗冠心病稳定型心绞痛临床疗效比较

Clinical efficacy of Dunye Guanxinning tablets and Compound Danshen dropping pills on stable angina pectoris of coronary heart disease

:70-73
 
目的 盾叶冠心宁片与复方丹参滴丸治疗冠心病稳定型心绞痛临床疗效比较。方法 选取于2017年10月—2018年10月至延安大学附属医院诊治的120例冠心病稳定型心绞痛患者。随机将所有患者分为2组,观察组患者在常规西药治疗基础上加服盾叶冠心宁片,对照组患者在常规西药治疗基础上加服复方丹参滴丸,比较两组患者治疗6个月后的临床疗效。结果 经过6个月治疗后,观察组患者的治疗有效率为66.7%,对照组患者的治疗有效率为40.0%。观察组与对照组治疗效果相比,差异有统计学意义(P<0.05)。盾叶冠心宁片治疗冠心病稳定型心绞痛的综合疗效优于复方丹参滴丸。结论 冠心病稳定型心绞痛患者在常规西药治疗不变的基础上加用盾叶冠心宁片,不仅能改善临床心绞痛症状,还能调节血脂异常及降低同型半胱氨酸水平,以及缓解患者情绪及睡眠问题,且安全性高,有较高临床应用价值。
Objective To compare the clinical efficacy of Dunye Guanxinning tablets and Compound Danshen dropping pills in the treatment of stable angina pectoris caused by coronary heart disease. Methods 120 patients with stable angina pectoris were selected from the affiliated hospital of Yan'an University from October 2017 to October 2018.All patients were randomly divided into two groups. The observation group was treated with Dunye Guanxinning tablets on the basis of conventional western medicine, while the control group was treated with Compound Danshen dropping pills on the basis of conventional western medicine. The clinical efficacy of the two groups was compared after 6 months of treatment. Results After 6 months of treatment, the effective rate was 66.7% in the observation group and 40.0% in the control group. The treatment effect of the observation group was statistical different from that of the control group (P<0.05). The comprehensive curative effect of Dunye Guanxinning tablets in treating stable angina pectoris of coronary heart disease is better than that of Compound Danshen dropping pills. Conclusion The use of Dunye Guanxinning tablets in patients with stable angina pectoris after conventional western medicine treatment may not only improve the symptoms of clinical angina pectoris, but also regulate dyslipidemia and reduce homocysteine level, as well as alleviate the patients' emotional and sleep problems. It has high safety and high clinical application value.
论著

2017—2018年汕头中心医院50例腹泻儿童鼠伤寒沙门菌临床分析

Clinical analysis of 50 diarrhea children Salmonella typhimurium in Shantou Central Hospital in 2017—2018

:66-69
 
目的 回顾分析2017—2018年汕头中心医院50例腹泻儿童鼠伤寒沙门菌的标本信息及药敏结果, 得出汕头地区这两年鼠伤寒沙门菌感染特性及指导临床合理用药。方法 从腹泻儿童粪便标本中分离沙门氏菌, 采用纸片扩散法检测其对抗菌药物的敏感性, 采用血清学凝集试验沙门氏菌血清型, 记录鉴定为鼠伤寒沙门菌的标本数据进行分析。结果 50例腹泻儿童鼠伤寒沙门氏菌中,易感时间多为夏秋季节;0~1岁为易感人群;感染后多出现发热、腹泻症状,可出现血便症状,较少出现呕吐;鼠伤寒沙门菌对亚胺培南、替加环素、厄他培南有100%的敏感率,对呱啦西林/他唑巴坦、头孢呱酮/舒巴坦有96%和92.68%的敏感率,队阿莫西林/克拉维酸有80.48%的敏感率,对阿米卡星、头孢呋辛酯、头孢呋辛、头孢西丁都为100%耐药,对其他抗生素有不同程度的敏感性及耐药性。结论 在夏秋季节,0~1岁儿童应加强对鼠伤寒沙门菌感染的预防,若出现发热、腹泻症状需及时就医,医生需向鼠伤寒沙门菌的方向考虑治疗,鼠伤寒沙门菌对多抗生素产生耐药性,临床上需根据药敏结果合理使用抗生素。
Objective To retrospectively analyze information and drug susceptibility of 50 cases of Salmonella typhimurium isolated from children with diarrhea in Shantou Central Hospital from 2017 to 2018, and to obtain the characteristics of Salmonella typhimurium infection in Shantou area in the past two years and to guide rational drug use in clinic. Methods Salmonella was isolated from fecal specimens of children with diarrhea. The susceptibility of Salmonella to antimicrobial agents was detected by disk diffusion method. Serological agglutination test was used to determine the serotype of salmonella. Sample data identified as Salmonella typhimurium were recorded and analyzed. Results Among the 50 children with diarrhea, the susceptibility time of Salmonella typhimurium was summer and autumn; the age of 0~1 was susceptible population; fever and diarrhea were common after infection, and hematochezia and vomiting were rare; Salmonella typhimurium had 100% susceptibility to imipenem, tegacycline and ertapenem, 96% and 92.68% to guacillin/tazobactam, cefotaxone/sulbactam. The sensitivity rate of amoxicillin/clavulanic acid was 80.48%. It was 100% resistant to amikacin, cefuroxime axetil, cefuroxime and cefoxitin. It had different sensitivity and resistance to other antibiotics. Conclusion In summer and autumn, children aged 0~1 should strengthen prevention of Salmonella typhimurium infection. If symptoms of fever and diarrhea occur, doctors should consider the direction of Salmonella typhimurium treatment. Salmonella typhimurium is resistant to multi-antibiotics, and rational use of antibiotics in clinic should be based on the results of drug sensitivity.
论著

中性粒细胞与淋巴细胞比值在晚期不可切除结直肠癌患者化疗疗效及预后的意义

Significance of neutrophil-lymphocyte ratio in chemotherapy curative effect and prognosis in patients with advanced unresectable colorectal cancer

:59-65
 
目的 评估中性粒细胞与淋巴细胞比值(NLR)在晚期结直肠癌(CRC)患者化疗疗效及预后的意义。方法 回顾性收集2016年1月—2019年4月期间接受以奥沙利铂为基础的标准一线化疗的晚期不可切除结直肠癌患者50例临床病历资料,并在2个化疗周期后评估化疗疗效;根据入组患者化疗前血液学数据计算中性粒细胞与淋巴细胞比值(NLR),运用受试者工作特征曲线确定的NLR最佳截断值,将患者分为高NLR(≥3.785) 组和低NLR(<3.785) 组,比较高、低NLR与临床病理特征、化疗疗效及无进展生存期(PFS)、总生存期(OS)差异;采用COX回归分析模型分析影响晚期结直肠癌患者PFS、OS的因素。结果 高、低NLR两组肿瘤分化程度(P=0.030)、ECOG评分(P=0.003)、CEA(P=0.011)、CA19-9(P=0.047)比较,差异有统计学意义;高低NLR两组间化疗疗效比较,差异有统计学意义(P<0.001),高NLR组化疗疗效较差;两组中位PFS分别为3.44个月和12.84个月,差异有统计学意义(χ2=39.730,P<0.001),两组中位OS分别为7.59个月和22.32个月,差异有统计学意义(χ2=40.505,P<0.001);Cox回归分析提示NLR高低、CEA水平是PFS、OS的独立预后因素(P<0.05)。结论 高水平NLR与晚期结直肠癌患者化疗疗效不佳和预后不良相关,可作为其化疗疗效及预后监测的指标。
Objective To evaluate the value of neutrophil-lymphocyte ratio (NLR) in the chemotherapy curative effect and prognosis of patients with advanced colorectal cancer (CRC). Methods Retrospective collection of clinical data from 50 patients with advanced unresectable colorectal cancer who received oxaliplatin-based standard first-line chemotherapy between January 2016 and April 2019. Chemotherapy curative effect was evaluated following 2 chemotherapy cycles. Calculation of neutrophil to lymphocyte ratio (NLR) based on pre-chemotherapy hematology data. The receiver operating characteristic curve was used to determine the optimal cutoff value of NLR,according to patients who were divided into groups of high NLR(NLR≥3.785)and low NLR(NLR≥3.785).The differences between high and low NLR and clinicopathological features, efficacy of chemotherapy, progression-free survival (PFS), and total survival (OS) were compared. COX regression analysis mode was used to analysis of factors affecting PFS and OS in patients with advanced colorectal cancer. Results The differences in tumor differentiation (P=0.030), ECOG score (P=0.003), CEA (P=0.011), CA19-9 (P=0.047) in the high and low NLR groups were statistically significant. The differences in chemotherapy between the two groups was statistically significant (P<0.001), and the high NLR group was less effective. The median PFS of the high and low NLR groups were 3.44 months and 12.84 months, respectively, and the difference was statistically significant (χ2=39.730, P<0.001). The median OS of the high and low NLR groups was 7.59 months and 22.32 months, respectively, and the difference was statistically significant (χ2=40.505, P<0.001). Cox regression analysis suggested that NLR levels and CEA levels were independent prognostic factors for PFS and OS(P<0.05). Conclusion High-level NLR is associated with poor chemotherapy response and poor prognosis in patients with advanced colorectal cancer, and was used as an indicator of chemotherapy efficacy and prognosis.
论著

增生期糖尿病视网膜病变经全视网膜激光治疗的临床观察

Clinical observation of proliferative diabetic retinopathy treated with panretinal laser photocoagulation

:55-58
 
目的 探讨增生期糖尿病视网膜病变患者经全视网膜激光光凝治疗的临床效果。方法 选取2016年2月—2019年3月我院收治的增生期糖尿病视网膜病变患者97例,使用随机数表法分为观察组(49例)与对照组(48例)。对照组患者接受黄斑格栅样光凝治疗,观察组患者则接受全视网膜激光光凝治疗。收集2组患者手术前后视力、黄斑中心凹容积、乳头周边视网膜神经纤维层厚度及视网膜厚度变化情况等数据进行分析,并对比生活质量评分。结果 治疗前,2组患者视乳头旁视网膜神经纤维层厚度、黄斑中心凹容积以及视网膜厚度之间差异无统计学意义(P>0.05),具有可比性。接受不同治疗后,观察组患者上述3项指标均优于对照组患者(P<0.05)。观察组患者治疗总有效率为79.59%,高于对照组患者治疗总有效率59.18%(P<0.05)。此外,观察组患者在精细动作、调节能力、日常生活及远视力、光感和移动4个维度评分均高于对照组患者(P<0.05)。结论 与黄斑格栅样光凝治疗相比,增生期糖尿病视网膜病变患者接受全视网膜激光光凝治疗有助于改善其乳头周边视网膜神经纤维层厚度和黄斑区视网膜厚度,能够显著促进视力恢复,提升患者生活质量,疗效确切。
Objective To investigate the clinical effect of panretinal laser photocoagulation for proliferative diabetic retinopathy. Methods 97 cases of proliferative diabetic retinopathy in our hospital from Feb 2016 to Mar 2019 were enrolled in the study, and were divided into 2 groups randomly. The control group received treatment of macular grid photocoagulation, while the observation group received whole retina laser photocoagulation. Data of visual acuity, macular fovea volume, retinal nerve fiber layer thickness around nipple and retinal thickness before and after operation were collected and analyzed, and quality of life scores were compared. Results Before treatment, there was no significant difference in retinal nerve fiber layer thickness, macular fovea volume and retinal thickness between the two groups (P>0.05), which was comparable. After different treatments, the three indexes mentioned above in the observation group were better than those in the control group (P<0.05). The total effective rate of the observation group was 79.59%, which was higher than that of the control group (59.18%, P<0.05). In addition, the scores of fine motion, accommodation ability, daily life and distant vision, light perception and movement in the observation group were higher than those in the control group (P<0.05). Conclusion Compared with macular grid-like photocoagulation, panretinal laser photocoagulation may improve the retinal nerve fiber layer thickness around the nipple and macular retinal thickness in patients with proliferative diabetic retinopathy. It promotes the recovery of visual acuity, improves the quality of life of patients, and has definite curative effect.
论著

30岁及以下乳腺癌术后首次复发转移特点分析

Analysis of the first recurrent pattern after radical surgery in breast cancer aged 30 years and younger

:50-54
 
目的 探讨分析30岁及以下青年乳腺癌患者术后首次复发转移特点,以期指导术后随访,早期发现转移病灶。方法 回顾性分析2003年1月—2018年8月在梅州市人民医院收治的年龄≤30岁乳腺癌患者73例,所有患者均行根治性手术治疗,分析临床病理特点及术后首次复发转移特点。结果 共纳入23例三阴性(31.5%)、20例luminal B(HER2-)型(27.4%)、12例HER-2阳性型(16.4%)、10例 Luminal B(HER2+)型(13.7%)、4例Luminal A型(5.5%)和4例分型不明(5.5%)。中位随访28.4个月,7例三阴性(7/23, 30.4%)、 6例HER-2阳性型(6/12, 50.0%)、 4例Luminal B(HER2-)型(4/20, 20.0%) 和3例 Luminal B(HER2+)型(3/10, 30.0%)出现复发转移。复发转移患者中,90.0%合并远处转移,75.0%合并内脏转移,其中HER-2阳性型均合并内脏转移;92.3%(12/13)激素受体阴性患者复发转移发生在术后2年内。三阴性患者最常见远处转移部位是远处淋巴结,HER-2阳性型患者最常见远处转移部位是肝,luminal B(HER2+)型患者最常见远处转移部位是肺和骨,luminal B(HER2-)型患者最常见远处转移部位是肺和远处淋巴结。结论 ≤30岁青年乳腺癌患者术后首次复发转移多合并远处转移,激素受体阴性患者容易早期复发,不同分子分型患者具有不同的好发远处转移部位。
Objective We retrospectively investigated the first recurrent pattern after radical surgery in breast cancer patients aged ≤30 years, so as to guide postoperative follow-up and early detection of recurrent lesions. Methods A total of 73 consecutive early breast cancer patients aged ≤30years admitted to Meizhou People's Hospital from January 2003 to August 2018 were included. Retrospective analysis was conducted to analyze the clinicpathologic characteristics and characteristics of first recurrent pattern. Results 23 triple negative(31.5%), 20 Luminal B(27.4%), 12 HER2 enriched (16.4%), 10 Luminal/HER2+(13.7%), 4 Luminal A(5.5%) and 4 undifined subtypes(5.5%) were included. After a median follow-up of 28.4 months, 20 patients relapsed, which included 7 triple-negative(7/23, 30.4%), 6 HER2-enriched (6/12, 50.0%), 4 luminal B(4/20, 20.0%) and 3 luminal/HER2+(3/10, 30.0%) subtypes. 90.0% of patients combined with distant metastasis. 75.0% of patients had visceral metastasis, which included all the recurrent HER-2 enriched patients. 92.3% of hormone receptor negative(HR-) patients had a RFS less than 2 years. The most common metastatic sites in triple-negative, HER-2-enriched, luminal/HER2+ and luminal B subtypes were distant nodes, liver, lung and bone, distant nodes and lung, respectively. Conclusion The first recurrent pattern mainly presented as distant metastasis in breast cancer patients aged≤30 years, with early relapse in patients with HR- diseases. Different molecular subtypes of breast cancer favor different distant metastatic sites.
论著

放射性 131I 在甲亢伴甲状腺结节中的应用价值

Application value of radioactivity 131I in hyperthyroidism with thyroid nodules

:46-49
 
目的 研究放射性 131I 在甲亢伴甲状腺结节中的应用价值。方法 纳入我院90例甲亢患者,根据其是否伴甲状腺结节分为无结节组(51例)、结节组(39例),均接受放射性 131I 治疗。比较两组治疗总有效率,分析两组治疗前后血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)及游离甲状腺素(FT4)水平。结果 无结节组治疗总有效率74.51%,结节组为58.97%,差异无统计学意义(P>0.05);两组治疗后TSH均高于治疗前(P<0.05),FT3、FT4均低于治疗前(P<0.05),TPOAb、TGAb较治疗前比较差异均无统计学意义(P>0.05);无结节组治疗后FT3、FT4低于结节组(P<0.05),TPOAb、TGAb、TSH较结节组比较差异均无统计学意义(P>0.05)。结论 放射性 131I 治疗甲亢伴甲状腺结节效果好,且操作简单,副作用少,值得临床推广使用。
Objective To study the value of radioactivity 131I in hyperthyroidism with thyroid nodules. Methods Ninety patients with hyperthyroidism in our hospital were divided into non-nodule group (51 cases) and nodule group (39 cases) according to whether they had thyroid nodules or not. All patients received 131I radiation therapy. The total effective rate was compared between the two groups. The serum levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were analyzed before and after treatment. Results The total effective rate was 74.51% in non-nodule group and 58.97% in nodule group, with no significant difference (P>0.05);after treatment, TSH was higher in both groups than that before treatment (P<0.05), FT3 and FT4 were lower than that before treatment (P<0.05), TPOAb and TGAb had no significant difference compared with that before treatment (P>0.05);FT3 and FT4 in nodule-free group were lower than those in nodule group (P<0.05). TPOAb, TGAb and TSH had no significant difference compared with nodule group (P>0.05). Conclusion Radioactive 131I treatment of hyperthyroidism with thyroid nodules has good effect, simple operation and few side effects, which is worthy of clinical application.
论著

不同手术治疗方案对甲状腺结节患者治疗合理性及临床效果的探讨

Discussion on the rationality and clinical effect of different surgical treatments for patients with thyroid nodules

:42-45
 
目的 探讨不同甲状腺结节手术治疗方案的合理性及临床效果。方法 选取本院2018年1月—2019年1月收治的120例患有甲状腺结节患者为研究对象,将其随机分为A组和B组各60例,A组患者未进行甲状腺细针抽吸细胞学检查直接进行甲状腺结节切除手术,B组患者接受超声负压引导甲状腺细针抽吸细胞学检查后给予手术治疗方案,比较两组患者手术前、后良恶性结节患者变化、术后复发率、并发症发生率及手术疗效。结果 术后A组残余恶性结节患者比例高于B组(P=0.001),A组健康无结节病变患者占比低于B组(P=0.002),A组患者恶性结节复发率高于B组患者(P<0.05);两组术后并发症发生率无差异(P>0.05),A组手术治疗总有效率低于B组(P<0.05)。结论 甲状腺结节患者术前有效超声穿刺诊断、术中超声引导手术及术后抗癌化疗治疗方案可以提高甲状腺结节患者手术有效率,B组方案具有重要临床推广价值。
Objective To investigate the rationality and clinical effect of different thyroid nodules surgical treatment. Methods A total of 120 patients with thyroid nodules admitted to our hospital from January 2018 to January 2019 were randomly divided into group A and group B, respectively. Group A patients did not undergo fine needle extraction. Aspiration cytology was performed directly for thyroid nodule resection. Group B patients underwent ultrasound negative pressure guided thyroid fine needle aspiration cytology and were given surgical treatment. The changes of benign and malignant nodules before and after surgery were compared between the two groups including postoperative recurrence rate, complication rate and surgical outcome. Results The proportion of patients with residual malignant nodules in group A was higher than that in group B (P=0.001). The proportion of patients with healthy no-nodular lesions in group A was lower than that in group B (P=0.002). The recurred rate of malignant nodules in group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The total effective rate of group A was lower than that of group B (P<0.05). Conclusion Preoperative effective ultrasound puncture diagnosis, intraoperative ultrasound guided surgery and postoperative anticancer chemotherapy treatment may improve the efficiency of thyroid nodules in patients with thyroid nodules. Group B has important clinical value.
论著

某院中期早产儿肠外营养及体格发育状况分析

Analysis of parenteral nutrition and physical development of premature infants

:39-41
 
目的 分析某院中期早产儿体格发育及肠外营养状况,为中期早产儿制定合理的肠外营养方案提供参考。方法 收集某院2017年10月—2018年12月50例(32~33+6)周早产儿的病例进行回顾分析。结果 50例患儿出生平均体质量、身长、头围各为(1.84±0.24) kg、(42.92±2.16) cm、(29.77±1.20) cm,生后 1周和生后2周的平均体质量、身长、头围分别为(1.83±0.24) kg、(43.28±1.95) cm、(29.97±1.32) cm和(2.07±0.23) kg、(43.91±1.79) cm、(30.62±1.13) cm。营养素的起始剂量各为:氨基酸(1.11±0.37)g·kg-1·d -1,脂肪乳(0.78±0.22)g·kg-1·d -1,葡萄糖(5.86±1.51)mg·kg-1·min-1,肠外营养平均天数(22.8±6.46)天,体质量平均下降幅度(7.22±3.82)%,恢复至出生体质量平均天数(8.3±2.72)天。结论 该院中期早产儿肠外营养设计需完善,以控制生理性体质量下降程度及持续时间,更适于体格发育。
Objective To analyze the physical development and parenteral nutrition status of preterm infant in a hospital in order to provide reference for the formulation of reasonable parenteral nutrition treatment plan for medium preterm infants. Methods The clinical data of 50 preterm infants aged 32~33+6 weeks from October 2017 to December 2018 were collected and analyzed retrospectively. Results The average birth weight, body length and head circumference of the child patients were (1.84±0.24) kg, (42.92 ±2.16) cm, (29.77±1.20) cm respectively. After one week and After two weeks,the average birth weight, body length and head circumference were(1.83±0.24) kg, (43.28±1.95) cm, (29.97±1.32) cm respectively and (2.07±0.23) kg, (43.91±1.79) cm, (30.62±1.13) cm respectively. The initial dose of amino acid(1.11±0.37)g·kg-1·d-1, fat emulsion(0.78±0.22)g·kg-1·d-1, glucose(5.86±1.51)mg·kg-1·min-1. The average days of parenteral nutrition treatment were(22.8±6.46)d, the average weight loss was(7.22±3.82)% and the average days of recovery to birth weight were (8.3±2.72)d. Conclusion The design of parenteral nutrition for preterm infants still needs to be improved in order to control the degree and duration of physiological weight loss of preterm infants in the mid-term, which is conducive to the physical development of preterm infants in the mid-term.
论著

基于网络药理学预测银杏叶治疗心肌缺血的作用机制

Prediction of the mechanism of Ginkgo leaf in the treatment of myocardial ischemia based on network pharmacology

:32-38
 
目的 基于网络药理学方法预测银杏叶治疗心肌缺血的潜在靶点及信号通路。方法 利用 TCMSP 平台筛选生物利用度(OB)≥ 30% 和类药性(DL)≥ 0.18 的活性成分及作用靶点。利用GeneCards和OMIM数据库检索心肌缺血疾病相关靶点,并提取药物成分和心肌缺血疾病的共有靶点作为关键靶点。通过在线TRING平台构建PPI网络,并采用Cytoscape 软件构建可视化的“化合物-靶点-通路”网络,进一步进行GO 功能富集分析和KEGG通路富集分析。结果 筛选得到 27种潜在的药效成分,2 164个化合物靶点,531个心肌缺血相关靶基因。两者取交集后获得疾病-类药活性成分40个共同靶点,PPI 蛋白互作网络自由度较高的节点依次为:IL6、VEGFA、CASP3、MAPK8、MYC、NOS3。GO 功能富集分析得到42个 GO 条目,KEGG 通路富集分析得到42条信号通路。结论 银杏叶治疗心肌缺血主要GO 能力富集在半胱氨酸肽链内切酶活性,内肽酶活力,激活转录因子结合,DNA结合转录激活剂活性,RNA聚合酶II特异性等功能,调控TNF信号通路,糖尿病并发症的年龄愤怒信号, 细胞凋亡,PI3K-Akt信号通路等信号,进一步达到对心肌缺血疾病的治疗。
Objective To predict the potential targets and signal pathways of ginkgo leaf in the treatment of myocardial ischemia based on network pharmacology. Methods The active components and targets of bioavailability (OB) ≥ 30% and drug-like (DL) ≥ 0.18 were screened by TCMSP platform.The related targets of myocardial ischemic diseases were searched by GeneCards and OMIM database, the components and the common targets of myocardial ischemic diseases were extracted as the key targets. To build the PPI network through the online STRING platform, a visual “compound-target-pathway” network was constructed to further analyze the functional enrichment of GO and the enrichment of KEGG pathway. Results 27 potential active components, 2 164 compound targets and 531 myocardial ischemia related target genes were screened. After the intersection of the two, 40 common targets of disease-class active components were obtained. The nodes with higher degree of freedom of PPI protein interaction network were IL6、VEGFA、CASP3、MAPK8、MYC and NOS3.42 entries were obtained by GO functional enrichment analysis and 42 signal pathways were obtained by KEGG pathway enrichment analysis. Conclusion Ginkgo leaf may be a target of cysteine-type endopeptidase activity,endopeptidase activity,activating transcription factor binding,DNA-binding transcription activator activity, RNA polymerase II-specific function. TNF signaling pathway, AGE-RAGE signaling pathway in diabetic complications, apoptosis, PI3K-Akt signaling pathway were regualted to achieve the treatment of myocardial ischemia disease.
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