充血性心力衰竭老年患者中医辨证分型及甲状腺激素及血浆BNP水平相关性临床观察.docVIP

充血性心力衰竭老年患者中医辨证分型及甲状腺激素及血浆BNP水平相关性临床观察 　 ; 作者：郦旦明 蒋蓝英 付仲颖 何炳荣 赵东杰 孙文丽 张晓君 【摘要】; 　　［目的］观察充血性心力衰竭（CHF）中医辨证分型与甲状腺激素、脑钠肽（BNP）、心功能参数的关系。［方法］将96例CHF患者分为4个证型组，检测各组心功能参数、BNP、甲状腺激素，并与对照组（21例）相同指标比较。［结果］CHF兼血瘀证组T3水平较对照组，心气虚证组，兼阴虚证组，均明显降低（Plt;0.05，Plt;0.05，Plt;0.05），兼水肿血瘀组T3水平较对照组，心气虚证组，兼阴虚证组，亦均明显降低（Plt;0.01，Plt;0.01，Plt;0.01），且兼水肿血瘀证组T3水平较兼血瘀证组亦明显降低（Plt;0.05）。同时，兼水肿血瘀组与对照组，心气虚证组，兼阴虚证组，兼血瘀证T4水平亦明显降低（Plt;0.05或Plt;0.01）；CHF兼血瘀证，兼水肿血瘀证较对照组，血浆BNP水平有显著升高（Plt;0.01﹞；心室重构指标亦有显著差异（Plt;0.05）。［结论］单纯T3降低或伴有T4降低，与BNP增高可能分别是CHF兼血瘀证，兼水肿血瘀组老年患者不同程度LVEF下降的重要原因之一。甲状腺激素、血浆BNP水平的变化同样是反映CHF老年患者中医辨证分型心功能变化的可靠指标。 【关键词】; 充血性心力衰竭 甲状腺激素 脑钠肽老年 辨证分型 　　Abstract：［Objective］To observe the relativity between congestive heart failure（CHF） differentiation types of TCM and thyroid gland hormone，BNP and heart function parameters.［Method］ Divide CHF patients into 4 groups，measure their heart function parameters，BNP and thyroid hormone，compare it to that of control group（21 cases）.［Result］ In CHF combined with blood stasis group，T3 level is much more reduced than that of control group and groups of heart Qi deficiency and combination of Yin deficiency（Plt;0.05，Plt;0.05，Plt;0.05）；so is to the combination of edema and blood stasis group(Plt;0.01，Plt;0.01，Plt;0.01），and it is lower than combination of blood stasis group（Plt;0.05）；meanwhile，its T4 level is much more lower than that of control one，and other groups of heart Qi deficiency，combination of yin deficiency and combination of blood stasisc Plt;0.05 or Plt;0.01）；for the groups of CHF combined with blood stasis，edema and blood stasis，plasm BNP level is raised obviously（Plt;0.01），the ventricle restructure index is much different too（Plt;0.05）.［Conclusion］ Pure T3 reduction or accompanied with T4 reduction，and BNP increase may be one of key reasons of reducing LVEF in different extent to senile patients of CHF combined with blood stasis，edema and blood stasis.Also the change of thyroid hormone and plasm BNP level is the reliable index reflecting heart function