冠心病心绞痛病人冠状动脉造影与中医辨证分型关系的研究

目的分析冠心病心绞痛病人冠状动脉造影结果,结合血脂等客观指标改变,以求找出一些规律,使中医辨证建立在更为客观科学的基础之上.方法参照世界卫生组织"缺血性心脏病的病名及诊断标准",选择89例病人进行选择性冠状动脉造影,按中国中西医结合学会心血管分会制订的冠心病中医辨证标准进行辨证,通过相关分析各证型与冠状动脉造影积分、血瘀证积分、瘀血舌象积分及血脂之间的关系.结果①阳虚证冠状动脉造影积分高于痰浊偏寒组,痰浊偏热组瘀血舌象积分高于痰浊偏寒组(P<0.05);②血瘀组与各组(痰浊偏热、血瘀、气滞、气虚、阴虚)的冠状动脉造影积分、心电图积分正相关;阳虚组与胆固醇、LDL-C呈正相关(P<0.05);③痰浊偏热组HDL-C比痰浊偏寒、寒凝组降低,阴虚组HDL-C比寒凝、血瘀气滞组降低(P<0.05);气虚组三酰甘油高于寒凝组(P<0.01);④痰浊偏热组LDH高于痰浊偏寒组(P<0.05),阴虚组乳酸脱氢酶(LDH)低于气滞、寒凝、阳虚组(P<0.01),气虚组LDH显著低于阳虚组(P<0.01);⑤血瘀证冠状动脉造影积分与瘀血舌象积分无相关性.结论①冠状动脉造影积分在阳虚证冠心病心绞痛最高,血瘀证积分密切相关;②痰浊偏热、阴虚热象明显者HDL-C偏低;寒象明显者胆固醇水平偏高,HDL-C也高;③瘀血舌象与冠状动脉造影异常之间没有必然联系.     

丹参粉针剂对氧化低密度脂蛋白诱导的内皮细胞表达MMP9及ICAM-1的影响

目的:研究丹参粉针剂对氧化低密度脂蛋白(ox-LDL)诱导的内皮细胞基质金属蛋白酶9(MMP9)及细胞粘附分子1(ICAM-1)表达的影响.方法:建立脐静脉内皮细胞模型,在培养液中加入ox-LDL致使脐静脉内皮损伤,分别加入130μg/ml、100μg/m1、75μg/ml、50μg/ml、25μg/ml5种浓度的丹参粉针剂溶液,观察丹参粉针剂对ox-LDL诱导内皮细胞损伤的保护作用.结果:ox-LDL可诱导脐静脉内皮细胞表达MMP9及ICAM-1,有效血药浓度内,75μg/ml、100μg/ml和130μg/ml的丹参粉针剂溶液可使MMP9及ICAM-1的表达下降.结论:丹参粉针剂可下调ox-LDL诱导的内皮细胞MMP9及ICAM-1的表达,对内皮细胞具有保护作用.     

Clinical Study on Effect of Garlicin in Stabilizing the Carotid Artery Atherosclerotic Plaque in Patients with Primary Hypertension and Coronary Artery Disease

Objective:To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (GAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).Methods:Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results:By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion:Garlicin could stabilize CMP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.