冠心病心绞痛中医证型与脑钠肽、C-反应蛋白和肌钙蛋白相关性研究

Correlation of Syndrome Patterns in Angina Pectoris Due to Coronary Heart Disease with Brain Natriuretic Peptide,C-reactive Protein and Troponin

目的:探讨冠心病心绞痛中医证型与脑钠肽(BNP)、C-反应蛋白(CRP)及肌钙蛋白(cTnI)的相关性。方法:将348例冠心病心绞痛患者(冠心组)分心血瘀阻、气阴两虚、气滞血瘀、痰阻心脉、气虚血瘀、心肾阴虚、阳气虚衰、阴寒凝滞等8个证型,并与同期302例健康体检者(健康组)作对照,观察冠心病心绞痛患者与健康体检者、冠心病心绞痛各证型之间BNP、CRP及cTnI的关系。结果:冠心组BNP、CRP、cTnI均高于健康组(P<0.01);阳气虚衰型BNP、CRP、cTnI最高,心血瘀阻、痰阻心脉、阴寒凝滞次之,即阳气虚衰>心血瘀阻、痰阻心脉、阴寒凝滞>气滞血瘀>气虚血瘀>心肾阴虚>气阴两虚。结论:BNP、cTnI、CRP可做为冠心病心绞痛的中医证型量化指标,用于评价冠心病心绞痛的中医证型严重程度,为临床辨证用药提供参考。

Objective:To investigate the correlation of syndrome patterns in angina poctofis due to coronary heart disease(CHD)with brain natfiuretic peptide(BNP),C- reactive protein(CRP)and troponin(cTnI).Methods:Three hundred and forty-eight patients with angina pectoris due to CHD were classified into heart-blood stagnation,de- ficiency of both Qi and yin,Qi stagnation and blood stasis,phlegm blocking heart ves- sels,Qi deficiency and blood stasis,heart-kidney yin deficiency,deficiency of yang- qi,and yin-cold stagnation.Three hundred and two healthy volunteers served as the controls.The relationship of syndrome patterns in angina pectofis patients and the healthy volunteers with BNP,CRP and cTnl was investigated.Results:The levels of BNP, CRP and cTnI were higher in the CHD group than those in the healthy group,and was the highest in CHD patients with deficiency of yang-qi.The levels of BNP,CRP and cTnI in CHD patients with different syndrome patterns were in a decreasing sequence as follows:deficiency of yang-qi,heart-blood stagnation,phlegm blocking heart ves- sels,yin-cold stagnation,Qi stagnation and blood stasis,Qi deficiency and blood sta- sis,heart-kidney yin deficiency,and deficiency of both Qi and yin.Conclusion:The levels of BNP,CRP and cTnI can be used as the reference parameters for evaluating the severity of syndrome patterns in CHD patients.