摘要
目的:本文通过文献回顾研究发现,既往关于冠心病痰瘀证实质的研究多从血脂及血液流变学异常角度论及,而少有从免疫炎症角度论述。本研究试图针对ACS痰瘀证研究的空白,从免疫炎症的角度出发,探讨急性冠脉综合征痰瘀证的实质,并分析了炎症因子与血脂分组间的相关性。方法:将90例急性冠脉综合征患者按照中医辨证标准分为痰瘀证组(55例)及非痰瘀证组(35例),另设健康对照组70例。分别检测CRP、FIB、IL-6、TNF-α及D-二聚体在痰瘀证及非痰瘀证组中的数值,分析急性冠脉综合症痰瘀证与炎症相关因子的关系。检测痰瘀证组、非痰瘀证组间TC、TG及LDL-C的数值变化。结果:急性冠脉综合症痰瘀证组CRP、TNF-α及D-二聚体显著高于非痰瘀证组(P<0.05、P<0.05、P<0.01),痰瘀证组FIB、IL-6虽高于非痰瘀证组,但差异未见显著性(P>0.05)。ACS痰瘀证组TC数值显著高于非痰瘀证组(P=0.025),其余TG及LDL-C在两组间的比较未见显著性差异(P均>0.05)。结论:本研究显示CRP、TNF-α及D-二聚体等炎症因子介导的免疫炎症活动与ACS痰瘀证的形成密切相关,可能是ACS痰瘀证形成的始动因素;而高血脂是急性冠脉综合征痰瘀证形成的物质基础;CRP、TNF-α、D-二聚体等免疫、炎症因子有可能成为ACS痰瘀证划分的客观指标。
Objective ： To study the relationship between Phlegm - blood stasis syndrome and inflammation in patients with acute coronary syndrome. Through a great amount documents retrospecting in this research, we found that, most of the studies about the reasons and mechanisms of the formation of CAD marked by phlegm - blood stasis syndrome, focus on the abnormity of lipoprotein and hemorheology, but few on immunity or inflammation. Pointing to the vacancy in the research of phlegm - blood stasis syndrome of ACS, we try to explore into the relationship among phlegm - blood stasis syndrome, we analyze some kind of inflammation mediums and blood lipid. Methods：90 ACS patients were divided into phlegmblood stasis group （55） and non -phlegm -blood stasis group （35） in accordance with the standard of the syndrome differentiation of TCM. 70 healthy people were in the control group . Detected the level of C - reactiveprotein （CRP） , fibrinogen （FIB） , interleukin - 6 （ IL - 6 ） , tumornecrosisfactor -αlpha （ TNF -α） , D - Dimer （ D - D ） of the phlemgm - blood stasis group and the non - phlegm - blood stasis group , in the meantime, analyzed the relationship between the phlegm - blood stasis of ACS and the inflammation mediums. The variety of the three kinds of lipid （TC, TG, LDL - C） between the phlegm - blood stasis group and the non - phlegm - blood stasis group were also studied. Results： The level of CRP , TNF -α and D - D in the phlegm - blood stasis group of ACS were all significantly higher than in the non - phlegm - blood stasis group （ P 〈0.05 ,P 〈 0.05 ,P 〈 0.01 ）. FIB and IL - 6 in the phlegm - blood stasis group were all higher than those in the non - phlegm - blood stasis group, but all the differences were not significant （ P 〉 0.05 ）. The numerical value of TC was significantly higher in phlegm - blood stasis group of ACS than that in non - phlegm - blood stasis group （ P = 0. 025 ）, but the difference of TG between the two groups was not significant （ P 〉 0.05 ）, neither was that of LDL - C. Conclusions ： This study suggests that the immunity and inflammation activities leaded by CRP,TNF-α, D -D, et al are highly related to the formation of phlegm -blood stasis syndrome of ACS , and the activities maybe the stimulate factor that accelerate the formation ; High blood lipid is the basic substance in the formation of phlegm - blood stasis syndrome of ACS; The immunity and inflammation mediums, such as CRP,TNF -α, D - D, et al , perhaps can be the impersonality indexes of syndrome differentiation of TCM about phlegm - blood stasis syndrome of ACS.
出处
《中国民康医学》
2008年第9期872-875,共4页
Medical Journal of Chinese People’s Health
关键词
急性冠脉综合征
痰瘀证
炎症介质
Acute Coronary Syndrome （ACS）
Phlegm -blood stasis syndrome
Inflammation mediums
