冠心病患者血栓弹力图与中医血瘀证的相关性研究

Correlation study on thromboela-stogram with blood stasis syndrome of TCM in patients with coronary heart disease

目的运用血栓弹力图(thromboela-stogram,TEG),评价冠状动脉粥样硬化性心脏病(冠心病)血瘀证患者的血栓风险。方法 74例冠心病患者中血瘀证组(XY)50例,非血瘀证组(NXY)24例。所有患者均进行TEG检测,比较2组患者TEG指标。结果2组凝血反应时间(R)比较,XY<NXY,组间比较差异有统计学意义(P<0.05);2组血凝块形成时间(K)比较,XY<NXY,组间比较差异有统计学意义(P<0.05);2组描记图最大曲线弧度切线与水平线的夹角(Angle)比较,NXY<XY,组间比较差异有统计学意义(P<0.05)。相关性分析显示:冠心病血瘀证与R(r=-0.840,P=0.000),K(r=-0.440,P=0.000),Angle(r=0.374,P=0.01)相关。经多元线性逐步回归分析显示,R、LY30为冠心病血瘀证的主要影响因素。结论冠心病血瘀证患者存在更高的血栓风险,应充分重视凝血功能的监测,并积极应用西医抗血小板药物及中医活血化瘀药物,以减少血栓事件的发生,降低临床死亡率。

Objective To evaluate the thrombogenesis risk in patients with coronary heart disease of blood stasis syndrome （BSS） by thromboela-stogram （TEG）. Methods Among 74 patients with coronary heart disease, there were 50 in BSS group （ XY group） and 24 in non-BSS group （NXY group）. All patients were given detection of thromboela-stogram （TEG） and the differences in TEG indexes were compared between the two groups. Results Levels of coagulation response time （R） in XY group were lower than those in NXY group, there was statistical significance in difference between the two groups （P 〈 0. 05 ）. Levels of blood clot formation time （K） in XY group were lower than those in NXY group, there was statistical significance in difference between the two groups （ P 〈 0. 05 ） ~ Level of angle in NXY was lower than the one in XY group, there was statistical significance in difference between the two groups （P 〈 0. 05）. The correlation analysis showed there was significant correlation between the occurrence of coronary heart disease of blood stasis syndrome （BSS） and R（ r = - 0. 840, P = 0. 000 ）, K （ r = - 0. 440, P = 0. 000）, Angle （ r = 0. 374, P = 0. 01 ）. Multiple linear regression analysis showed that R, LY30 were the major factors for the occurrence of coronary heart disease of blood stasis syndrome （BSS）. Conclusion Since there exist higher risks of thrombogenesis in patients with coronary heart disease of BSS , it is important to monitor the coagulation function, apply anti-platelet medicines and the herbal drugs for blood-activating and stasis- dispelling in order to reduce the incidence of thrombogenesis and clinical mortality.