冠心病患者血清磷脂转运蛋白及胆固醇脂转运蛋白水平与中医证型相关性研究

Study on the Correlation between Chinese Medical Syndrome Types and Serum Levels of PLTP and CETP in Coronary Heart Disease Patients

目的探讨冠心病患者血清磷脂转运蛋白(phospholipid transfer protein,PLTP)、胆固醇酯转运蛋白(cholesteryl ester transfer protein,CETP)水平与中医病证的相关性,为冠心病证候客观化和开发临床治疗药物探索新的途径。方法选择经冠状动脉造影确诊为冠心病的患者201例,采用国内外公认标准,构建证候四诊合参数据库,进行中医辨证。随机选取健康体检者20名为健康对照组。取静脉血分离血清,分别以酶联免疫法测定血清PLTP、CETP表达;采用乙酰丙酮显色法测定甘油三酯(triglyceride,TG)含量;采用沉淀漂浮酶联法测定总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)含量。结果各证型冠心病患者血清PLTP、CETP、TC明显高于健康对照组,差异有统计学意义(P<0.05,P<0.01);各证型组血清TG、HDL-C、LDL-C与健康对照组比较,差异有统计学意义(P<0.05,P<0.01)。标实证组各证型血清PLTP与本虚组各证型比较,差异有统计学意义(P<0.05)。标实证组各证型血清TG、HDL-C、LDL-C与本虚组各证型比较,差异有统计学意义(P<0.05、P<0.01)。结论标实证冠心病患者血清PLTP表达明显升高。标实证冠心病患者血清脂质改变较本虚证更为显著。

Objective To study the correlation between the serum levels of phospholipid transfer protein（PLTP）,cholesteryl ester transfer protein（CETP）,and Chinese medical syndrome types of coronary heart disease（CHD） patients,thus probing a new pathway for the objectivity of CHD syndrome typing and developing therapeutic drugs.Methods 201 patients with CHD confirmed by coronary angiography were selected.The comprehensive analysis database by the four examination methods was established using generally accepted standard for Chinese medical syndrome typing.Twenty healthy subjects were randomly recruited as the control group.Serum samples were separated from venous blood.The serum activities of PLTP and CETP were assayed by ELISA.The triglyceride（TG） content was determined using acetic acetone coloring method.Contents of total cholesterol（TC）,high-density lipoprotein cholesterol（HDL-C）,and low-density lipoprotein cholesterol（LDL-C） were determined using precipitation floating enzyme couplet method.Results Serum levels of PLTP,CETP,and TC of CHD patients of all Chinese medical syndrome types were significantly higher than those of the control group,showing statistical difference（P0.05,P0.01）.Statistical difference existed in serum levels of TG,HDL-C,and LDL-C of all Chinese medical syndrome types when compared with the control group（P0.05,P0.01）.Statistical difference existed in serum levels of PLTP between the sthenia in superficiality groups of all Chinese medical syndrome types and the asthenia in origin groups of all Chinese medical syndrome types（P0.05）.Statistical difference existed in serum levels of TG,HDL-C,and LDL-C between the sthenia in superficiality groups of all Chinese medical syndrome types and the asthenia in origin groups of all Chinese medical syndrome types（P0.05,P0.01）.Conclusions The serum PLTP levels of CHD patients of sthenia in superficiality significantly increased.Changes in serum lipids was more significant in CHD patients of the sthenia in superficiality syndrome than in those of the asthenia in origin syndrome.