老年冠心病患者的血清瘦素水平临床意义及其与中医证型的相关性研究

Serum leptin levels in elderly patients with coronary heart disease and clinical significance and correlation with TCM syndromes

目的:探讨老年冠心病患者的血清瘦素水平的变化及其与中医证候的相关性。方法:选取河南中医学院第一附属医院老年病科2012年2月-2014年2月收治的65例老年冠心病患者,根据病情分为稳定型心绞痛组(22例)、不稳定型心绞痛组(35例)及急性心肌梗死组(8例),并收集20例排除冠心病老年人作为对照组,应用ELISA法进行血清瘦素水平检测,并进行统计学分析。比较各组冠心病患者及对照组血清瘦素水平。将65例老年冠心病患者随机分入四个中医证型组,测定其空腹血清瘦素水平、血脂、体重指数等值,记录并评价指标。结果:血清瘦素水平冠心病各组明显高于正常对照组(P<0.05),不稳定型心绞痛组及急性心肌梗死组高于稳定型心绞痛组(P<0.05),急性心肌梗死组高于不稳定型心绞痛组(P<0.05),血清瘦素水平与冠心病病变程度呈正相关(r=0.60,P<0.05),冠心病各组与正常对照组比较有统计学意义(P<0.05)。其中痰浊内阻证患者血清瘦素水平高于其他证型。结论:老年冠心病患者血清瘦素水平明显增高,血清瘦素水平检测对老年冠心病严重程度具有较好的预测价值。其水平增高与痰浊内阻型冠心病密切相关,冠心病患者血清瘦素水平升高为冠心病(胸痹)中医辨证分型的客观化研究提供了一个新的思路。

Objective:To observe the changes in elderly patients with coronary artery disease and its relationship with serum leptin levels syndromes correlation. Methods:65 cases of elderly patients with coronary heart disease were divided into stable angina group (22 cases), unstable angina group (35 cases) and acute myocardial infarction group (eight cases), and collected 20 cases of coronary heart disease exclude older people as a control group, the application of serum leptin levels by ELISA testing and statistical analysis. Comparison of patients in each group and the control group, serum leptin levels coronary heart disease. The 65 cases of elderly patients with coronary heart disease were randomly divided into four groups syndromes, measured fasting serum leptin levels, cholesterol, body mass index equivalent, recording and evaluation. Results: Serum leptin levels were significantly higher than those with coronary heart disease each normal control group (P<0.05), unstable angina and acute myocardial infarction group than stable angina group (P<0.05), acute myocardial infarction, unstable angina group than in the group (P<0.05). Serum leptin levels and coronary artery disease severity was positively correlated (r=0.60, P<0.05). Coronary heart disease in each group and the normal control group was statistically significant (P<0.05). Phlegm resistance syndrome and syndrome Yang Qi decline in serum leptin levels were better than other syndromes. Conclusion:Serum leptin levels were significantly higher in elderly patients with coronary heart disease, serum leptin levels detected with better predictive value for the severity of coronary heart disease in elderly. It is closely related to increased levels of coronary heart disease with phlegm resistance, elevated serum leptin levels in patients with coronary heart disease is coronary artery disease (chest stuffiness) TCM type of objective study provides a new way of thinking.