冠心病痰瘀辨证与相关生化指标关系探讨

目的:探讨冠心病(CHD)痰瘀辨证与高敏C反应蛋白(hsCRP)、D-二聚体(DD)、纤维蛋白原(Fb)、脂蛋白(a)Lp(a)]水平及冠状动脉造影(CAG)结果的关系.方法:将经CAG确诊的CHD患者82例及CAG阴性者15例,测CAG检查前血hsCRP、DD、Fb、Lp(a)水平.应用CAG的Gensini积分方法评价冠状动脉粥样硬化及其程度.CHD患者经中医痰瘀辨证后分为非痰非瘀、痰凝心脉、痰瘀痹阻证,分析与hsCRP、DD、Fb、Lp(a)水平及Gensini积分的相关性.结果:CAG检查阳性者hsCRP、DD指标水平均显著高于CAG检查阴性者(P均<0.01),CAG检查阳性者Fb、Lp(a)水平与CAG检查阴性者无显著差异(P>0.05).从非痰非瘀、痰凝心脉到痰瘀痹阻,血hsCRP、DD、Fb、Lp(a)水平逐渐增高,Gensini积分亦逐渐增高,血hsCRP、DD、Fb、Lp(a)水平与Gensini积分之间有相关性.结论:血hsCRP、DD、Fb、Lp(a)水平可为冠心病痰瘀辨证分型提供依据,冠心病痰瘀辨证分型严重程度也与冠脉狭窄程度和病变支数呈正相关.

Discussion on Phlegm Stasis Type of Coronary Heart Disease and Corresponding Biochemistry Indexes

Objective: To explore the relationship between phlegm stasis type of coronary heart disease(CHD) and corresponding indexes, including plasma high sensitivity C reactive protein, D dimer,fibrinogen, liproprotein(a) and result of coronary ateriography(CAG). Methods: The levels of the blood hsCRP, DD, Fb, Lp(a) in 82 cases of CHD diagnosed by CAG and 15 cases without CHD were examined. The incidence and serious degree of coronary atherosclerosis were evaluated by CAG and the Gensini's scores. The patients with CHD were classified into three groups: the non phlegm and non stasis group, the phlegm stasis group and the phlegm stagnation group. Their relationship withblood hsCRP, DD, Fb, Lp(a) were analyzed.Results: The levels of hsCRP and DD in the patients with CHD were markedly higher than those in the patients without CHD. The leves of Fb and Lp (a) in patients with and without CHD had no difference. The levels of blood hsCRP, DD, Fb and Lp (a) were improved gradually from the non-blood stasis non-phlegm group, the phlegm stasis group to the phlegm stagnation type as well as Gensini integration. It showed the blood hsCRP, DD, Fb and Lp (a) were related with Gensini integration.Conclusion: The levels of blood hsCRP, DD, Fb and Lp (a) can provide effective index of phlegm stasis type of coronary heart disease. The serious degree is also related with the coronary atherosclerosis and the number of coronary with atherosclerosis.