冠心病病人中医证型与血脂及内皮依赖性舒张功能的相关性研究

Relationship between Traditional Chinese Medicine Syndrome Types and Blood Lipid Level and Endothelium-dependent Relaxing Function in Coronary Heart Disease

目的探讨冠心病病人内皮依赖性舒张功能改变、血脂的改变与中医证型之间的相关性。方法选择冠心病病人184例,观察内皮依赖性舒张功能、血脂改变与中医证型之间的相关性。结果内皮依赖性舒张功能在冠心病痰瘀相兼证病人中受损最重;其次为痰浊证、血瘀证;非痰非瘀证受损较轻。总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)等脂代谢异常指标在痰、瘀证中有不同程度升高;高密度脂蛋白胆固醇(HDL-C)则相反,在痰、瘀证中有不同程度降低;其中痰瘀相兼证与非痰非瘀证之间差异有统计学意义(P<0.05)。高胆固醇组与血脂正常组的肱动脉内径基础值之间差异无统计学意义(P>0.05),反应性充血时肱动脉内径变化的百分比在高胆固醇血症组明显减弱,与血脂正常组比较差异有统计学意义(P<0.01)。硝酸甘油介导的血管扩张差异有统计学意义(P<0.05)。高三酰甘油组与血脂正常组肱动脉内径基础值差异无统计学意义(P>0.05);反应性充血引起肱动脉内径的变化在高三酰甘油血症组明显减弱,与血脂正常组比较差异有统计学意义;含服硝酸甘油后肱动脉内径均明显扩张,但两组间肱动脉内径的变化差异无统计学意义。结论冠心病病人中医各证型、内皮依赖性舒张功能和血脂水平之间有一定的相关性。

Objective To study the relationship between traditional Chinese medicine （TCM）syndrome types and blood lipid changes and endothelium dependent relaxing function in patients（pts）with coronary heart disease（CHD）.Methods One hundred and eighty four patients with CHD were col ected.The correlation between endothelium dependent relaxing function,blood lipid changes and TCM syndrome type was observe.Results The endothelium dependent relaxing function in pts with CHD phase and phlegm and blood stasis syndrome were most seriously damaged,fol owed by phlegm turbidity syndrome,blood stasis syndrome.The damage was the lightest in pts with non phlegm stasis syndrome.The levels of total cholesterol（TC）,triglyceride（TG）,and low density lipoprotein （LDL）in pts with phlegm syndrome and stasis syndrome were increased whilethe levels of high density lipoprotein（HDL）were re-duced.There were obvious difference in phlegm and blood stasis syndrome andnon phlegm non stasis syndrome（P〈0.05）.There was no significant difference in the brachial artery diameter base value between high cholesterol group and normal control group（P〉0.05）,while reactive hyperemia of inner diameter changes of the brachial artery in primary hypercholesterolemia group decreased significantly,compared with normal control group had obvious difference （P〈0.01）.Nitroglycerin mediated vasodilation has signifi-cant difference （P〈0.05）.There was no obvious difference in brachial artery diameter value between high triglycerides group and normal group（P〉0.05）.The brachial artery diameter caused reactive hyperaemia changes decreased significantly in the high blood triglycerides group,compared with the normal group had significant difference.After administering nitroglycerin brachial artery diame-ter were significantly expanded,but changes in brachial artery diameter between the two groups have no significant difference.Con-clusion There are some relations with blood lipid level and endothelium dependent relaxing function and TCM syndrome types in pts with CHD.