冠心病慢性心力衰竭血脂改变与证候及冠脉造影结果的相关性研究

目的:探讨冠心病慢性心力衰竭血脂改变与常见中医证型及冠脉造影(CAG)结果之间的关系,为临床诊疗提供指导。方法:分析冠心病慢性心力衰竭常见中医证型、血脂异常情况、CAG结果之间的关系。结果:总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)及载脂蛋白(a)Lp(a)]等脂代谢异常指标在气阴两虚证、心肾阳虚证、气虚血瘀证、痰瘀互组证中有不同程度升高,HDL则逐步降低;气阴两虚证、心肾阳虚证、气虚血瘀证与痰瘀互阻证之间有明显差异(P<0.05)。随着病变支数的增多,TC、TG、LDL的水平逐渐升高,多支病变的LDL水平与单支病变、双支病变比较有统计学意义(P<0.05);HDL水平在单支病变、双支病变、多支病逐渐降低;各组间Lp(a)差异有统计学意义(P<0.05)。随着狭窄程度的加重,TC、TG、LDL及Lp(a)水平逐渐增高,重度狭窄与轻度狭窄比较有统计学意义(P<0.05);HDL则逐渐降低,重度狭窄与轻度狭窄比较亦有统计学意义(P<0.05)。结论:冠心病慢性心力衰竭血脂改变与常见证候及CAG结果之间有一定的相关性。

Relationship Between the Common Syndrome of Chronic Heart Failure Coronary Heart Disease and the Changes of Blood Lipids

Objective：Discussion relationship between the common syndrome of chronic heart failure coronary heart disease and the changes of blood lipids, provide the instruction for the clinical care. Methods ： Observes the relations between the changes of blood lipids and TCM syndrome,CAG results in patients of chronic heart failure coronary heart disease. Results：Total cholesterol （TC）, triglyceride （TG）, low density lipoprotein （LDL） and apolipoprotein（a）Lpa] and other indicators of abnormal lipid metabolism in qi and yin deficiency syndrome, heart-kidney yang deficiency syndrome, qi deficiency blood stasis syndrome, phlegm and blood group card has increased to varying degrees, HDL is gradually reduced;qi and yin deficiency syndrome, heart-kidney yang deficiency syn- drome, qi deficiency blood stasis syndrome have significant difference between deficiency with phlegm and blood group card （P（ 0.05）. With the increase in lesion count,TC,TG,LDL levels gradually increased, the level of LDL multi-vessel disease and singlevessel disease, double vessel disease was statistically significant （P〈0.05） ;HDL levels in single-vessel disease , double vessel disease, multivessel disease gradually reduced; each group Lp（a） the difference was statistically significant（P〈0.05）. As the severity of stenosis,TC, TG, LDL and Lp （a） levels gradually increased, with severe stenosis and mild stenosis was statistically significant （P d0.05） ; HDL, in contrast,severe stenosis is also compared with mild stenosis statistically significant （P〈0.05）. Conclusion： The changes of blood lipids have some relations with the common syndrome and CAG results in patients of chronic heart failure coronary heart disease.