目的:筛查冠心病血瘀证病证结合相关基因。方法:区组选择符合诊断标准的冠心病血瘀证、冠心病非血瘀证、非冠心病血瘀证患者和正常健康者共40例,运用外周血mRNA差异显示获得差异条带、反向Northern法阳性验证、克隆测序,并进行生物信息学分析。结果:得到了28条真实差异基因片段序列,于NCBI human genomic数据库中比对分析,获得了与人类基因100％同源的3条（b13、49b、23b）,99％同源的2条（b12、36a）,98％同源（25b、57d）2条。其中的b13为淋巴细胞活化信号分子家族成员1,表达于T、B细胞表面,参与多系统的炎症反应,促进Th2类细胞因子的分泌,在冠心病血瘀证组呈高表达。23b系BCL2相关转录因子1,参与凋亡调控基因BCL2的转录过程,明显表达于冠心病血瘀证组。结论:差异基因中b13、 23b从不同途径,导致或参与了脂代谢、血液高粘高聚高凝状态的形成,并通过分泌炎性细胞因子,调控细胞凋亡,参与了内皮损伤和动脉硬化的形成。与冠心痛血瘀证的病理改变密切相关。

Objective: To search for relevant genes linking to the blood - stasis diseases of coronary heart disease one by one. Method To Choose 40 cases and divide them into groups of coronary heart disease, non-blood-stasis diseases of coronary heart disease, blood - stasis diseases of non-coronary heart disease and healthy people, according to diagnostic criteria, and obtain their differential strips by the display of the difference of pripheral blood mRNA, their positive proof by Revrese Northern Method and the sequence of their clones and analyze their bio - information. Result: 28 sequences of gene fragments with real difference are caught, of which 3 （b13, 49b and 23b） are 100% homologous with human genes; 2 （b12 and 36a）, 99% ; and 2 （25b and 36a）, 98% through comparison and analysis in NCBI human genomic database, among which b13 is of the member No.1 of the family of activated signals which assumes on the surface of T. B cells, takes effects in the imflammation of multiple systems, fosters th secretion of cell factors of Th2 type and are highly experessed in the group of blood-stasis diseases, and 23b is of relevant transcription factor No. 1, which participates in the transcription process of apoptosis regulation gene BC12 and is remarkably expressed in the group of blood -stasis diseases of coronary heart disease. Conclusion: b13 and b23 in the differential genes lead to or participate in lipo-metabolism and the formation of high - viscosity, high polymeric and high- concentration states of blood from different ways and means and are involved in the formation of endothelial damage and arteriosclerosis due to the secretion of inflammatory cell factors and the regulation of cell apoptosis. They are closely related to the pathological change of the blood-stasis diseases of coronary heart disease.

国家重点基础研究发展计划(973)资助项目(2003CB517103):冠心病心绞痛病证结合的诊断标准与疗效评价体系研究子课题,负责人:王阶;中国中医研究院创新工程基金(CS-00-02):中国中医研究院创新工程基金，负责人:王阶。