单纯性高甘油三酯血症辨证分型与自由基代谢及凝血-纤溶活性关系的研究

Study on the relationship between free radical metabolism as well as coagulantfibrinolytic activity and syndrome differentiation of traditional Chinese medicine in hypertriglyceridemia

目的 :研究单纯性高甘油三酯血症辨证分型与自由基代谢及凝血纤溶活性的关系。方法 :选择血清甘油三酯 >1.8mm ol/ L患者 ,按中医辨证分为气虚证组 (2 5例 )、阴虚证组 (2 6例 )、阳虚证组 (2 0例 )、痰湿证组 (2 4例 )和血瘀证组 (2 5例 ) ,并设立对照组 (2 5例 ) ,比较各组血浆丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH Px)、内皮素 (ET)、一氧化氮 (NO)、血小板α颗粒膜蛋白 (GMP 14 0 )、组织型纤溶酶原激活剂 (t PA)及其抑制剂 (PAI)等指标的差异。结果 :高甘油三酯血症各证型 ET、MDA、PAI、GMP 14 0均高于对照组 ,而 NO、SOD、GSH Px、t PA均较之为低 (P均 <0 .0 1) ;痰湿证组、血瘀证组 ET、MDA、PAI、GMP 14 0、SOD、GSH Px均高于气虚证组、阴虚证组与阳虚证组 ,而 NO、t PA则较低 (P均 <0 .0 1) ;阳虚证组 SOD、GSH Px则较气虚证组与阴虚证组显著降低 (P均 <0 .0 1)。结论 :各证型均存在不同程度的自由基代谢紊乱及凝血纤溶系统的改变 ,痰湿证及血瘀证存在较明显脂质过氧化反应增强、血管内皮细胞功能障碍、血小板活化、纤溶活性降低等改变 ,阳虚证组抗氧化酶活性降低。

Objective:To study the relationship between free radical metabolism as well as coagulantfibrinolytic activity and syndrome differentiation of traditional Chinese medicine(TCM) in hypertriglyceridemia(HTG).Methods:The patients whose triglyceride>1 8 mmol/L were divided into 4 groups according to syndrome differentiation of TCM:Qideficiency syndrome(气虚证) group (group A,25 cases),Yindeficiency syndrome(阴虚证) group (group B,26 cases),Yangdeficiency syndrome(阳虚证) group (group C,20 cases),phlegmdampness syndrome(痰湿证) group (group D,24 cases),and bloodstasis syndrome(血瘀证) group (group E,25 cases).The serum malonyldialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidation(GSHPx),endothelin(ET),nitric oxide (NO),tissue plasminogen(tPA),plasminogen activator inhibitor(PAI),αgranule membrane protein140(GMP140)were measured and compared with those of 25 healthy subjects.Results:The levels of ET,MDA,PAI,GMP140 in all HTG groups were significantly higher and NO,SOD,GSHPx,tPA were significantly lower than those of control group(all P <0.01).The levels of ET,MDA,PAI,GMP140,SOD and GSHPx were significantly higher and NO,tPA were significantly lower in group D,E than those of group A,B,C(all P <0.01).SOD,GSHPx of group C were lower than those of group A,B(all P <0.01).Conclusions:The disorder of free radical metabolism as well as coagulantfibrinolytic activity in each type are occured in different degree.The enhancement of lipid peroxidation,damage of vascular endothelial cells,activation of platelet and reduction of fibrinolytic activity are more marked in group D,E than those of the other groups and there is lowest activity of antioxidative enzyme in group C.