血液流变性改变与冠心病中医证型关系研究

目的探讨血液流变学改变与中医证型的关系。方法通过冠状动脉造影术（CAG），观察冠心病患者血液流变学与中医证型、CAG结果之间的关系。结果全血高切、低切黏度，血浆黏度，全血高切、低切还原黏度，纤维蛋白原，红细胞聚集指数等血流变指标在痰、瘀证中均有不同程度的升高，而红细胞变形指数有不同程度的降低。痰证组突出表现在纤维蛋白原、血浆黏度的异常升高；瘀证组则突出表现在红细胞变形指数的异常降低，其它指标的异常升高在痰瘀相兼组中更为突出。全血高切、低切黏度，血浆黏度，全血高切、低切还原黏度，纤维蛋白原，红细胞聚集指数等血流变指标随着冠状动脉的狭窄程度的加重而逐渐升高，红细胞变形指数则逐渐降低。重度狭窄突出表现在全血高切、低切黏度，以及全血高切、低切还原黏度的异常升高。随着单支病变、二支病变、多支病变组全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、全血高切还原黏度、全血低切还原黏度、纤维蛋白原定量、红细胞聚集指数逐渐升高，红细胞变形指数逐渐降低。结论血液流变学改变与冠心病中医证型之间有一定关系。

The Research on the Relationship Between Hemorheology Changes and TCM Syndrome Type of Coronary Heart Disease

Objective： To discuss the relation between the hemorheology changes（HC） and type of TCM syndromes and to guide cfinical treatment. Methods： To analyze the relationship between the HC and type of TCM syndromes in patients with coronary heart disease and the results of coronary angiography by CAG. Results： Rheology index of blood including low notch viscosity（WBLNV） and high notch viscosity of the whole blood（WBHNV）, plasma viscosity（PV）, low（WBLSRV） and high shear reverting viscosity of the whole blood（WBHSRV）, plasma fibfinogen （PF） and rbc aggregation index（rbcAl） were increased in phlegm syndrome group（Ps group） and stagnation syndrome group（Ss group）, but the results of rbc deformability index（rbeDI） were decreased in the same groups. Ps group showed significant increasing results of PF and PV and Ss group showed abnormal reduce of rbcDl, but other observed index were insignificant increased in phlegm and stagnation syndrome group. Compared to the rbcDI, WBLNV, WBHNV, PV, WBLSRV, WBSHRV, PF and rbcDI were increased gradually with the aggravation of coronary arterial stenosis. While severe stenosis happened, WBLNV, WBHNV, WBLSRV, WBSHRV were abnormal increased. The rbcDI appeared gradually decreased with the increased of WBHNV, WBLNV, WBLSRV, WBSHRV, PV, hematocrit, WBHSRV, WBLSRV, PF and rbcAl in the single - branch lesion group, two - branch lesion group and muhi- branch lesion group. Conclusion： Some relationship does exist between the HC and TCM type of coronary heart disease.