冠心病中医证型血清Hcy与血浆vWF Ps hs-CRP TXB_2 6-keto-PGF_(1α)相关性研究

Clinical Study of Relationships between Serum Hcy and Plasma vWF,Ps,hs—CRP,TXB_2,6-keto-PGF_(lα) Respectively in CHD with Various TCM Syndromes

目的:对冠心病中医各证型Hcy水平与血浆vWF、Ps、hs-CRP、TXB2、6-keto-PGF1α水平相关性的临床研究,为冠心病的中医辨证分型提供客观依据,指导冠心病Hcy的辨证论治。方法:将冠心病患者152例中医辨证分为心血瘀阻、痰阻心脉、阴寒凝滞、心肾阴虚、气阴两虚、阳气虚衰6组,测定血清Hcy、血浆vWF、Ps、hs-CRP、TXB2、6-keto-PGF1α。结果:血清Hcy及血浆vWF、Ps、6-keto-PGF1α、TXB2水平心血瘀阻、痰阻心脉两型均高于心肾阴虚、气阴两虚两型(P<0.05)。冠心病各证型组间血浆hs-CRP水平两两比较均无显著性差异(P>0.05)。心血瘀阻、痰阻心脉两型血清Hcy水平与血浆vWF、Ps、TXB2水平呈正相关关系(P<0.01)。心肾阴虚、气阴两虚两型血清Hcy水平与血浆6-keto-PGF1α水平呈负相关关系(P<0.05)。冠心病各证型组血清Hcy水平与血浆hs-CRP水平均呈正相关性(P<0.01)。结论:本研究提示,血清Hcy水平可作为冠心病的辨证分型的客观依据之一。心肾阴虚、气阴两虚两型Hcy主要是通过损伤内皮细胞的功能,治宜补虚;而心血瘀阻、痰阻心脉则是在损伤内皮细胞基础上,降低内皮细胞抗血栓能力,促使动脉粥样硬化,治宜祛邪。

Objective：The Objectives of our study is to provide an objective proof for syndrome differentiation of traditional Chinese medecine（TCM） and guide clinical treatment and syndromes in coronary heart disease（CHD） by investigating the rela- tionships between serum homocysteine（Hcy） and plasma vWF, Ps, hs - CRP, TXB2,6 - keto - PGF1α respectively. Methods：The patients with CHD were divided into 6 groups,such as heart blood stasis, retention of phlegm in heart vessel, stagnation of qi due to cold, heart - kidney yin deficiency, dnal seficiency of qi and yin, dual deficiancy yang and qi. Results ： Serum Hcy levels and Plasma vWF ,Ps, FIB ,TXB2 levels of stagnation of heart vessel group. Retention of phlegm in heart vessel group were statistically higher than those of heart - kidney yin deficiency group, dnal seficiency of qi and yin group respectively （ P 〈 0.05 ）. There were significantly positive correlation between serum Hcy levels and plasma vWF,Ps,TXB2 levels of heart blood stasis group and retention of phlegm in heart vessel group respectively（ P 〈 0.05 ）. There were significantly negative correlation between serum Hcy levels and Plasma 6 -keto -PGFlαlevels of heart -kidney yin deficiency group and dnal seficiency of qi and yin group respectively （ P 〈 0. 05 ）. There were significantly positive correlation between serum Hcy levels and plasma hs - CRP levels of every group of CHD respectively（ P 〈 0. 05 ）. Conclusions：Serum Hcy level may be served as an objective proof for differential TCM syndromes of CHD. Heart- kidney yin deficiency, dual deficiency of qi and yin can injury the function of endothelial cells （Ecs）, should be treated by invigorating asthenia; heart blood stasis, retention of phlegm in heart vessel also can decrease the antithrombotic eapility of Ecs and promote the extent of atherosclerosis, should be treated by eliminating pathogentic factors.