LP-PLA2、sd LDL-C、Hcy在冠心病中医证型中的临床价值及其与冠脉病变程度的相关性

Clinical value of LP-PLA2,sd LDL-C and Hcy in TCM syndromes of coronary heart disease and its correlation with coronary lesions

目的探讨脂蛋白相关磷脂酶A2(LP-PLA2)、小而密低密度脂蛋白胆固醇(sd LDL-C)、同型半胱氨酸(Hcy)水平在冠心病(CHD)患者不同中医证型的价值及与冠脉病变程度的相关性。方法通过对2018年3~12月在聊城市中医医院心病科门诊和住院患者已确诊的300例冠心病患者,根据冠心病8种中医证型与同期40例健康对照组,进行一般资料以及实验室检测LP-PLA2、sd LDL-C、Hcy、GLU、HDL-C、LDL-C、TC、TG指标水平。结果1.证型分布呈现气虚血瘀>气滞血瘀>痰阻心脉>气阴两虚>心血瘀阻>阳气虚衰>心肾阴虚>寒凝心脉。2.各中医证型与对照组比较,LDL-C、GLU、sd LDL-C、Hcy、LP-PA2与对照组比较,P<0.05;中医证型中气虚血瘀证、气滞血瘀证、痰阻心脉证、心血瘀阻证、寒凝心脉证的sd LDL-C、Hcy、LP-PA2水平显著高于气阴两虚证、阳气虚衰证、心肾阴虚证、对照组(P<0.05)。3.冠脉狭窄程度与sd LDL-C、Hcy、LP-PA2水平呈正相关,根据三项指标水平可推断CHD患者各中医证型狭窄程度依次为痰阻心脉证>心血瘀阻证>气虚血瘀证>气滞血瘀证>寒凝心脉证>气阴两虚证>阳气虚衰证>心肾阴虚证。结论sd LDL-C、Hcy、LP-PA2水平与冠心病狭窄程度呈正相关,在冠心病各中医证型冠脉病变程度辅助诊断上的有一定的参考。

Objective To explore the value of lipoprotein-associated phospholipase A2(LP-PLA2),small low-density lipoprotein cholesterol(sd LDL-C)and homocysteine(Hcy)levels in different TCM syndromes in patients with coronary heart disease(CHD)and the correlation with coronary lesions.Methods A total of 300 patients with coronary heart disease who had been diagnosed in the outpatient department of cardiology and hospitalized in of Traditional Chinese Medicine from March 2018 to December 2018 were enrolled as TCM syndromes groups according to 8 TCM syndrome types of coronary heart disease.And 40 healthy controls in the same period were enrolled as the control group.General data analysis and laboratorytests for LP-PLA2,sd LDL-C,Hcy,GLU,HDL-C,LDL-C,TC,TG indicators were performed on them.Results 1.Syndrome type distribution showed qi deficiency and blood stasis>qi stagnation and blood stasis>tanzu xinmai>qi and yin deficiency>heart and blood stasis>yang qi deficiency>heart and kidney yin deficiency>hanning xinmai.2.There were no significant differences in LDL-C,GLU,sd LDL-C,Hcy,and LP-PA2 between the different TCM syndromes groups and the control group(P<0.05).In different TCM syndromes groups,the levels of sd LDL-C,Hcy,and LP-PA2 in groups with qi deficiency and blood stasis,qi stagnation and blood stasis,tanzu xinmai,heart and blood stasis,and hanning xinmai were significantly higher than those of groups with qi and yin deficiency,yang qi deficiency,heart and kidney yin deficiency,and control group(P<0.05).3.The degree of coronary stenosis was positively correlated with the levels of sd LDL-C,Hcy and LP-PA2.According to the three indicators,it can be inferred that the degree of stenosis of TCM syndromes in patients with CHD was tanzu xinmai syndrome>heart and blood stasis syndrome>qi deficiency and blood stasis syndrome>qi stagnation and blood stasis syndrome>hanning xinmai syndrome>qi and yin deficiency syndrome>yang qi deficiency syndrome>heart and kidney yin deficiency syndrome.Conclusion The levels of sd LDL-C,Hcy and LP-PA2 are positively correlated with the degree of coronary heart disease stenosis.It has a certain reference value in the diagnosis of coronary heart disease with different TCM syndromes.