冠心病稳定型心绞痛中医证型与血管内皮功能相关性研究

Relevance Study between Chinese Medicine Syndromes and Vascular Endothelial Function in Stable Angina of Coronary Heart Disease

目的探讨冠心病稳定型心绞痛中医证型与血管内皮功能的关系。方法应用超声检测稳定型心绞痛患者心血瘀阻组、痰浊壅塞组、气滞心胸组各30例及20例正常对照组FMD及NMD,采用酶联免疫吸附法或硝酸还原酶法检测血浆中的ET-1、vWF、TM及NO水平。结果与正常对照组相比,3组患者均具有较低的FMD(P<0.05),心血瘀阻组最低;与正常对照组、痰浊壅塞组、气滞心胸组相比,心血瘀阻组患者具有较低的NMD(P<0.05);与正常对照组相比,3组患者均具有较低的NO(P<0.05),其中心血瘀阻组最低;与正常对照组、气滞心胸组相比,心血瘀阻组、痰浊壅塞组患者具有较高的ET(P<0.05),其中心血瘀阻组最高;与其余3组相比,心血瘀阻组患者具有较高的vWF(P<0.05);与正常对照组相比,3组患者具有较高的TM(P<0.05)。以心血瘀阻证的出现为因变量,进行二分类Logistic回归分析,结果显示FMD为保护因素(ORFMD=0.159),年龄为危险因素(OR年龄=1.325)。结论不同中医证型间,患者存在不同的内皮功能,其中心血瘀阻证内皮功能最低;FMD为心血瘀阻型心绞痛发生的保护因素,年龄为其出现的危险因素。

Objective To explore the relationship between Chinese medicine syndromes and vascular endothelial function in stable angina of coronary heart disease.Methods The echocardiography was adopted to detect FMD and NMD in heart blood stagnation group,phlegm blockage group,qi stagnation in the heart and chest group,30 cases in each one,as well as 20 cases in normal control group.ELISA or nitrate reductase assay was applied to detect the levels of ET-1,vWF,TM and NO in plasma.Results Compared with normal control group,FMD was lower in all three groups（P0.05）,of which,FMD was the lowest in heart blood stagnation group.Compared with normal control group,phlegm blockage group and qi stagnation of the heart and chest group,NMD was lower in heart blood stagnation（P0.05）.Compared with normal control group,NO was lower in all three groups（P0.05）,of which,it was the lowest in heart blood stagnation group.Compared with normal control group and qi stagnation in the heart and chest group,ET was higher in heart blood stagnation group and phlegm blockage group（P0.05）,of which,it was the highest in heart blood stagnation group.Compared with the rest three groups,vWF in heart blood stagnation group was the highest（P0.05）.Compared with normal control group,TM was higher in three groups（P0.05）.The occurrence of heart blood stagnation syndrome was taken as the dependent variable for bivariant logistic regression.The Results indicated that FMD was the protective factor（ORFMD=0.159）and age was the risk factor（ORAGE=1.325）.Conclusion Among different syndromes in TCM,the patients presented various endothelial functions,of which,the endothelial function is the lowest in heart blood stagnation syndrome.FMD is the protective factor and age is the risk factor of the occurrence of angina in heart blood stagnation syndrome.