冠心病患者单核细胞凝血/纤溶活性改变与中医证型关系

Relationship between Changes of Coagulant and Fibrinolytic Activity of Monocyte in Coronary Heart Disease Patients and Different Syndrome Type of TCM

目的 :研究冠心病患者单核细胞凝血 纤溶活性改变与中医辨证分型的关系。方法 :80例冠心病患者分为血瘀证组 30例 ,痰浊证组 2 7例 ,气滞证组 2 3例 ,另设健康对照组 2 0例 ;采用发色底物法分别检测外周血单核细胞 (PBMC)促凝活性 (PCA)、组织型纤溶酶原激活物 (t PA)及其抑制物 (PAI 1)活性。结果 :冠心病各组与健康对照组比较 ,PBMCPCA、PAI 1表达均显著升高 ,而t PA表达显著下降 (P <0 0 1) ;血瘀证与非血瘀证组 (痰浊与气滞组 )之间PBMCt PA、PCA表达有显著差异 (P <0 0 1) ,而PAI 1表达无差异 (P >0 0 5) ;痰浊证组与气滞证组之间各项指标未见差异 (P >0 0 5)。结论 :冠心病患者单核细胞凝血 纤溶活性改变与中医辨证分型之间有一定的相关性 ,PBMCPCA增高和t PA降低的程度对区别血瘀证和非血瘀证具有意义 ,血瘀证患者处于明显的血栓前状态。

To study the relationship between changes of coagulant and fibrinolytic activity of human peripheral blood monocyte (PBMC) in coronary heart disease (CHD) patients and different syndrome type of Traditional Chinese Medicine (TCM). Methods:80 patients with coronary heart disease were divided into three groups by syndrome differentiation. 30cases of blood stasis (BS), 27cases of phregm damp(PD) and 23cases of Qi stagnation(QS). 20 healthy persons were enrolled as normal control group. Activity of tissue type plasminogen activator(t PA) and its inhibitor (API 1) and procoagulant activity (PCA) of PBMC were measured by chromogenic substrate method respectively. Results: PAI 1 activity and PCA expression of PBMC in the CHD group were significantly higher while t PA activity of PBMC was lower than those in the normal control group ( P <0 01). PCA expression of PBMC in the BS group was significantly higher than that in PD and QS groups, PBMC t PA expression in BS group was lower than that in PD and QS groups ( P <0 01). No significant difference of PAI 1 activity of PBMC was found among BS、PD and QS groups ( P >0 05). All param3eters were found no significant difference between PD and QS groups ( P >0 05). Conclusions: There is a relationship between changes of coagulant and fibrinolytic activity of monocyte in coronary heart disease patients and different syndrome type of TCM. The increasing level of PBMC PCA and reducing level of PBMC t PA could be used as referential indices for differentiating BS and NBS(PD and QS). Patients of BS were in the notable prethrombotic state.