冠心病痰瘀辩证与高敏C反应蛋白、D-二聚体、纤维蛋白原、脂蛋白(a)及冠脉造影结果的关系

Relationship between phlegm stasis type of clinical with blood hsCRP、DD、Fb、Lp(a) and severity of coronary atherosclerosis in patients with coronary heart disease

目的 探讨冠心病 (CHD)痰瘀辩证与高敏C反应蛋白 (hs CRP)、D 二聚体 (DD)、纤维蛋白原 (Fb)、脂蛋白 (a) [Lp(a) ]水平及冠状动脉造影 (CAG)结果的关系。方法 82例经CAG确诊的CHD患者及 15例CAG阴性者 ,检测入院后CAG手术前血hsCRP、DD、Fb、Lp(a)水平。应用CAG的Gensini积分方法评价冠状动脉粥样硬化及其程度。CHD患者经中医痰瘀辩证后分为非痰非瘀、痰凝心脉、痰瘀痹阻证 ,分析与hsCRP、DD、Fb、Lp(a)水平及Gensini积分的相关性。结果 CAG阳性者hsCRP、DD指标水平均显著高于CAG阴性者 (P均 <0 .0 1) ,CAG阳性者Fb、Lp(a)水平与CAG阴性者无显著差异 (P >0 .0 5 )。从非痰非瘀、痰凝心脉到痰瘀痹阻 ,血hs CRP、DD、Fb、Lp(a)水平逐渐增高 ,Gensini积分亦逐渐增高 ,血hs CRP、DD、Fb、Lp(a)水平与Gensini积分之间有相关性。结论 血hs CRP、DD、Fb、Lp(a)水平可为冠心病痰瘀辩证分型提供依据 。

Objective To explore into the relationship among phlegm stasis type of clinical with plasma high-sensitivity C-reactive protein, D-dimer, fibrinogen, lipoprotein(a) and severity of coronary atherosclerosis in patients with coronary heart disease(CHD).Methods There were 82 patients with CHD and 15 subjects without CHD(Control), all cases were performed coronary arteriography (CAG). The blood hsCRP,DD,Fb,Lp(a) were examined before CAG. The incidence and severith of coronary atherosclerosis were evaluated by CAG and the Gensini's scores. The patients with CHD were classified into three group: the neither blood stasis nor phlegm type, the phlegm stasis type and the phlegm stagnation type. Results Comparing the patients with the control group, there was significant difference in the two items: hsCRP,DD positively correlated with each other.Conclusion The 4 items were effective index to the phlegm stasis type of clinical. The phlegm stasis pathogenesis ascertained by overall analysis of clinical evidences were positively correlated with the severith of coronary atherosclerosis and the number of coronary with atherosclerosis.