颈动脉内膜-中层厚度及高敏C反应蛋白与不稳定型心绞痛中医证型的关系

Study on Relationship between the Levels Including IMT and hs-CRP and TCM Syndrome Differentiation-type in Unstable Angina Pectoris

目的探讨不稳定型心绞痛(UAP)中医证型及临床危险度分层与颈动脉内膜-中层厚度(IMT)及高敏C反应蛋白(hs-CRP)的关系。方法将患者按Braunwald UAP分类法进行临床危险度分层,并按冠心病中医辨证标准进行辨证分型;入选的107例UAP患者及30例对照组均检查IMT及hs-CRP。结果 UAP患者IMT及hs-CRP水平明显高于对照组,随着临床危险度的增高而有明显差别;UAP患者血清hs-CRP水平与颈动脉IMT呈正相关;UAP患者血瘀证、痰浊证、痰瘀互结证到气虚血瘀证,IMT及hs-CRP均呈现不断增高的趋势。结论 hs-CRP及IMT与UAP的诊断及危险分层存在相关性,对于UAP的预测及危险度判断具有重要意义;UAP的中医辨证分型与IMT及hs-CRP存在相关性,IMT及hs-CRP作为中医辨证分型的客观化、量化指标有一定的临床价值。

Objective：To explore the relationship between the two indices including the imtima-media thickness（IMT） and the high-sensitivity C-reactive protein（hs-CRP） and the TCM syndrome differentiation-type of unstable angina pectoris（UAP）.Methods：107 patients with UAP were divided into three different clinical risk levels according to Braunwald UAP clinical risk level criterion.These patients were differentiated by the TCM syndrome differentiation for coronary heart disease.The IMT and the hs-CRP were observed in 107 patients with UAP and 30 controlled cases.Results：The hs-CRP and the IMT in the UAP patients were higer obviously than those in the control group.There were remarkably differences in those indices as the clinical risk degree increasing.There was a positive correlation between the hs-CRP level and the IMT.There were continuously increase trends in the IMT and the hs-CRP from the blood stasis syndrome,the phlegm turbid syndrome,the phlegm and blood stasis syndrome and the qi deficiency and blood stasis syndrome.Conclusion：The clinical risk level of UAP had relation to levels including IMT and hs-CRP.They are important meanings in diagnosing and judging the clinical risk level of UAP.TCM-SDT in UAP had relation to the level of IMT and hs-CRP,It was valuable in clinical practise that IMT and hs-CRP were regarded as objective marker of TCM-SDT.