心绞痛不同血瘀证型与冠心病危险因素和炎症因子相关性.pdfVIP

提 要 目的：分析冠心病心绞痛不同血瘀辨证分型的分布规律，探讨不同血瘀证型与冠 心病危险因素及炎症指标的相关性，以及稳定型心绞痛与不稳定型心绞痛的差异性。 方法：将 150 例冠心病心绞痛血瘀证患者根据四诊辨证分为气虚血瘀、痰浊血瘀、 气滞血瘀、血虚血瘀、寒凝血瘀、热毒血瘀 6 种类型，采集患者临床资料，测定患者 血清中炎症指标 IL-6、Lp-PLA2 ，建立 SPSS 数据库，首先对整体资料进行基础资料、 证型分析，然后对证型与冠心病危险因素及合并疾病之间进行了 logistic 回归分析； 最后针对合并疾病与证候的相关性、证型与炎症指标的相关性做了 logistic 回归或多 元逐步回归分析。 结果：冠心病心绞痛血瘀证不同证型中气虚血瘀、痰浊血瘀、血虚血瘀、气滞血 瘀为心绞痛血瘀证的常见证型；气虚血瘀与 Lp-PLA2、痰浊血瘀与 BMI、血虚血瘀与 糖尿病、热毒血瘀和吸烟、BMI等存在相关性：不稳定型心绞痛患者较稳定型心绞痛 患者 LDL 、Hs-CRP、IL-6、Lp-PLA2 水平显著升高，HDL 显著降低；Hs-CRP、IL-6 呈正相关，Lp-PLA2与LDL呈正相关，与HDL呈负相关。 结论：心绞痛血瘀证不同证型与冠心病危险因素存在内在联系，炎症因子之间以 及与部分危险因素之间存在相关性，Lp-PLA2可能对冠心病的发生发展有促进作用。 关键词 心绞痛；血瘀证；IL-6 ；LP-PLA2 ；临床研究 The Correlation between Different Blood Stasis Syndromes and Risk Factors of Coronary Heart Disease and Inflammation Indexes in Angina Pectoris patients Speciality: Internal Medicine of TCM Tutor: Ji Wenyan Author: Wang Shanshan Abstract Objective: To analyse the distribution of different Blood Stasis Syndromes of Angina Pectoris, to explore the correlation between different Blood Stasis Syndromes of Angina pectoris and risk factors and inflammation indexes of Coronary Heart Disease and to investigate the difference between stable and unstable Angina pectoris. Method: One hundred and fifty patients of blood stasis syndromes of angina were categorized into six groups based on the four examination methods of Chinese medicine syndrome typing. They were cases of qi-deficiency blood stasis syndrome, phlegm blocked blood stasis syndrome, blood deficiency blood stasis syndrome, stagnant of qi blood stasis syndrome, toxic heat blood stasis syndrome and cold coagulation blood stasis syndrome. The clinical data of the patients were collected and the levels of high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6)