急性冠脉综合征中医辨证分型与丝裂原活化蛋白激酶、内脂素等炎症因子的相关性

Correlation of Traditional Chinese Medical Syndrome Differentiation of Acute Coronary Syndrome with Inflammatory Factors of Mitogen-activated Protein Kinases and Visfatin

【目的】探讨急性冠脉综合征(acute coronary syndrome,ACS)中医辨证分型与丝裂原活化蛋白激酶(mitogenactivated protein kinases,MAPK)、内脂素(Visfatin)等炎症因子相关性,为ACS的中医辨证分型提供客观依据。【方法】对64例符合纳入标准的ACS患者进行中医辨证分型,采用免疫散射比浊法及酶联免疫吸附测定(ELISA)等方法检测外周血中炎症反应相关指标超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP-9)、Visfatin、MAPK等的表达情况,分析证候类型与实验指标的相关性。【结果】ACS常见中医证候为痰浊闭塞证、气滞血瘀证、阴血虚证、阳气虚证;在ACS的4种证型中,痰浊闭塞证及气滞血瘀证的hs-CRP、IL-6、MCP-1、MMP-9、Visfatin、MAPK浓度均显著高于阴血虚证及阳气虚证,差异有统计学意义(P<0.05);而痰浊闭塞证与气滞血瘀证组间比较、阴血虚证与阳气虚证组间比较,差异均无统计学意义(P>0.05)。【结论】ACS患者的中医证型与血清hs-CRP、Visfatin、MAPK等炎症因子浓度有一定的相关性。

Objective To investigate the correlation of traditional Chinese medical syndrome differentiation of acute coronary syndrome （ACS） with inflammatory factors of mitogen-activated protein kinases （MAPK） and Visfatin, thus to supply subjective evidence for the syndrome differentiation of ACS. Methods Sixty-four qualified ACS patients were classified into various traditional Chinese medical syndrome patterns, and their expression levels of peripheral inflammatory factors such as high-sensitivity C-reactive protein （hs-CRP） , interleukin-6 （IL-6）, monocyte chemotactic protein-1 （MCP-1）, matrix metalloproteinase-9 （MMP-9）, Visfatin and MAPK were detected by immuno-scattering turbidimetry and enzyme-linked immunosorbent assay （ELISA） And then the correlation of syndrome patterns with the laboratory indexes was analyzed. Results The commonly-seen syndrome patterns in ACS patients were phlegm-turbidity obstruction, qi stagnation and blood stasis, yin-blood deficiency, and yang-qi deficiency. The first two excessive patterns had higher expression levels of hs-CRP, IL-6, MCP-1, MMP-9, Visfatin and MAPK than the latter two deficiency patterns （P〈0.05） . The differences of the observation indexes were insignificant between the first two excessive patterns and between the latter two deficiency patterns （P〉0.05）. Conclusion Certain correlation has been shown between the syndrome patters and inflammatory factors levels of hs-CRP, Visfatin and MAPK in ACS patients.