冠心病辨证与血凝纤溶系统关系的临床研究

Clinical Study the Relation CHD Syndrome Differentiation with Coagulation and Fibrinolysis System

目的:探讨凝血纤溶系统的变化与冠心病(CHD)辨证的关系。方法:在对269例冠心病人临床辨证的基础上,检测分析CHD各证型病人及健康对照组的抗凝血酶Ⅲ(ATⅢ)、血小板α颗粒膜蛋白(GPM-140)、纤溶酶原激活物抑制物(PAI-1)、组织型纤溶酶原激活物(t-PA)等血凝纤溶系统指标。结果:较之健康对照组,冠心病的各证型组的异常均有显著性意义(均P<0.01)。各证型组之间比较,心血瘀阻证和痰阻心脉证的5项指标异常的程度最明显,尤以心血瘀阻证为著。结论:①抗凝血指标(ATⅢ)的变化与冠心病临床辨证具有一定的相关性。②GMP-140显著升高可作为冠心病监测和血栓前状态评价的有效指标。③冠心病各证型均存在纤溶活性(t-PA与PAI-1)低下状态,心血瘀阻和痰阻心脉证尤为显著。

Objective ： to probe relation syndrome differentiation. Methods： detection and magglutination fibrinolytic system indicators of the between coagulation and fibrinolysis system changes and CHD analysis AT Ⅲ, GPM - 140, PAI- 1, t - PA and so on he- CHD different syndrome type and control group. Results： Abnormality of CHD different syndrome type showed significant difference Comparison with control group （P 〈 0. 01 ）. Heart blood stasis syndrome and phlegm syndrome 5 indicators abnormality showed the most obvious, particular in heart blood stasis. Conclusion： ①change of antcoagulant indicators has relation with CHD clinical syndrome differentiation. ②Significantly increased GMP - 140 can take as the effective indicator in CHD monitoring and evaluation of the prethrombotic state. ③low fibrinolytic activity exist in the CHD different syndrome type, particular in heart blood stasis and phlegm syndrome.