冠心病不同中医证型患者PCI术后Lp-PLA2水平的对比研究
发布时间：2019-07-03 14:03
【摘要】：目的:本研究通过检测入选研究对象血浆Lp-PLA2的水平,了解冠心病三种中医证型(痰浊证、血瘀证和气虚证)患者PCI术后Lp-PLA2水平的差异,探讨PCI术后增高的Lp-PLA2水平在冠心病哪一中医证型患者中居多,分析冠心病中医证型患者冠脉病变的严重程度,预测不同中医证型患者PCI术后冠状动脉再发狭窄的可能性大小。方法:拟选取广东省中西医结合医院2016年4月-2016年12月心血管内科住院的并行PCI术的冠心病病人75例作为研究组,根据中医辨证分型标准分为三型:痰浊证、血瘀证和气虚证。对照组为该时段内健康体检者25例(年龄在40-90岁之间,男女均可)。符合条件的对照组人群在入院时空腹抽血、研究组分别在术后第1天及第4天空腹抽血,两组间Lp-PLA2水平均采用免疫增强比浊法测定。比较研究组与健康对照组的Lp-PLA2的水平,并且比较冠心病不同中医证型组患者PCI术后第1、第4天血浆Lp-PLA2的水平,对比三组西医类型冠心病患者经皮冠状动脉介入术后不同时段Lp-PLA2的差异。研究的结果采用SPSS 19.0进行数据分析。结果:1、冠心病PCI术研究组术后第1天、第4天Lp-PLA2水平均高于健康对照组,差异有统计学意义(P0.05)。2、冠心病PCI术后第1天三组不同中医证型患者间Lp-PLA2水平不相等,经两两比较,Lp-PLA2水平由高到低为痰浊证血瘀证气虚证。3、冠心病PCI术后第4天三组不同中医证型患者间Lp-PLA2水平不相等,经两两比较,Lp-PLA2水平由高到低为痰浊证血瘀证气虚证。4、冠心病PCI术后第1天三组不同西医类型冠心病患者间Lp-PLA2水平各有差异,经统计学比较,Lp-PLA2水平由高到低为AMIUAPSAP。5、冠心病PCI术后第4天三组不同西医类型冠心病患者间Lp-PLA2水平各不相同,经两两比较,Lp-PLA2水平按照AMIUAPSAP的顺利排列。结论:Lp-PLA2作为一种强烈的血管促炎因子,可以评价冠脉病变的活动性,是冠脉病变严重程度的评估指标,可以作为冠心病三种不同西医类型患者PCI术后出现冠脉再狭窄可能性大小的判断指标;冠心病不同中医辨证分型患者间PCI术后Lp-PLA2水平存在明显的差别,可以为冠心病的中医辨证提供客观依据、指导冠心病的中医药临证用药,也可作为判断冠心病哪种中医证型患者PCI术后再发狭窄可能性更大的客观指标。
[Abstract]:Objective: to investigate the difference of Lp-PLA2 level among three TCM syndromes of coronary heart disease (phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome) by detecting the level of plasma Lp-PLA2 in patients with coronary heart disease, to explore which TCM syndrome type of coronary heart disease has increased Lp-PLA2 level in which TCM syndrome type of coronary heart disease, and to analyze the severity of coronary artery disease in patients with traditional Chinese medicine syndrome type of coronary heart disease. To predict the possibility of recurrent coronary artery stenosis after PCI in patients with different TCM syndromes. Methods: 75 patients with coronary heart disease hospitalized in Department of Cardiovascular Medicine from April 2016 to December 2016 in Guangdong Integrated traditional Chinese and Western Medicine Hospital were selected as the study group. According to the syndrome differentiation criteria of traditional Chinese medicine, they were divided into three types: phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome. The control group was 25 healthy subjects (between 40 years old and 90 years old, both male and female). Fasting blood was drawn from the eligible control group on admission, and fasting blood was drawn on the 1st and 4th day after operation, and the levels of Lp-PLA2 were measured by immunoturbidimetry. The levels of Lp-PLA2 in the study group and the healthy control group were compared, and the plasma Lp-PLA2 levels in the patients with different TCM syndrome types of coronary heart disease were compared on the 1st and 4th day after PCI, and the differences of Lp-PLA2 in the three groups of patients with coronary heart disease at different time points after percutaneous coronary intervention were compared. The results were analyzed by SPSS 19.0. Results: 1. The level of Lp-PLA2 in the study group was significantly higher than that in the healthy control group on the 1st and 4th day after operation (P 0.05). 2, the level of Lp-PLA2 in the three groups on the first day after PCI was not equal. Through pairwise comparison, the level of Lp-PLA2 was phlegm, turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 3, On the 4th day after PCI, the level of Lp-PLA2 was not equal among the three groups of patients with different TCM syndromes. By pairwise comparison, the level of Lp-PLA2 was from high to low for phlegm and turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 4. On the first day after coronary heart disease PCI, there were differences in Lp-PLA2 level among the three groups of different western medicine types of coronary heart disease. After statistical comparison, the level of Lp-PLA2 was AMIUAPSAP.5, from high to low. On the 4th day after PCI, the levels of Lp-PLA2 in the three groups were different among different types of coronary heart disease (CAD). By pairwise comparison, the Lp-PLA2 levels were arranged smoothly according to AMIUAPSAP. Conclusion: Lp-PLA2, as a strong vascular pro-inflammatory factor, can evaluate the activity of coronary artery disease, is an index to evaluate the severity of coronary artery disease, and can be used as an index to judge the possibility of coronary restenosis in patients with three different types of coronary heart disease after PCI. There are obvious differences in Lp-PLA2 level among different TCM syndrome differentiation patients of coronary heart disease after PCI, which can provide objective basis for TCM syndrome differentiation of coronary heart disease, guide the clinical use of traditional Chinese medicine for coronary heart disease, and can also be used as an objective index to judge which TCM syndrome type of coronary heart disease patients have greater possibility of recurrent stenosis after PCI.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4
本文编号：2509450
[Abstract]:Objective: to investigate the difference of Lp-PLA2 level among three TCM syndromes of coronary heart disease (phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome) by detecting the level of plasma Lp-PLA2 in patients with coronary heart disease, to explore which TCM syndrome type of coronary heart disease has increased Lp-PLA2 level in which TCM syndrome type of coronary heart disease, and to analyze the severity of coronary artery disease in patients with traditional Chinese medicine syndrome type of coronary heart disease. To predict the possibility of recurrent coronary artery stenosis after PCI in patients with different TCM syndromes. Methods: 75 patients with coronary heart disease hospitalized in Department of Cardiovascular Medicine from April 2016 to December 2016 in Guangdong Integrated traditional Chinese and Western Medicine Hospital were selected as the study group. According to the syndrome differentiation criteria of traditional Chinese medicine, they were divided into three types: phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome. The control group was 25 healthy subjects (between 40 years old and 90 years old, both male and female). Fasting blood was drawn from the eligible control group on admission, and fasting blood was drawn on the 1st and 4th day after operation, and the levels of Lp-PLA2 were measured by immunoturbidimetry. The levels of Lp-PLA2 in the study group and the healthy control group were compared, and the plasma Lp-PLA2 levels in the patients with different TCM syndrome types of coronary heart disease were compared on the 1st and 4th day after PCI, and the differences of Lp-PLA2 in the three groups of patients with coronary heart disease at different time points after percutaneous coronary intervention were compared. The results were analyzed by SPSS 19.0. Results: 1. The level of Lp-PLA2 in the study group was significantly higher than that in the healthy control group on the 1st and 4th day after operation (P 0.05). 2, the level of Lp-PLA2 in the three groups on the first day after PCI was not equal. Through pairwise comparison, the level of Lp-PLA2 was phlegm, turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 3, On the 4th day after PCI, the level of Lp-PLA2 was not equal among the three groups of patients with different TCM syndromes. By pairwise comparison, the level of Lp-PLA2 was from high to low for phlegm and turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 4. On the first day after coronary heart disease PCI, there were differences in Lp-PLA2 level among the three groups of different western medicine types of coronary heart disease. After statistical comparison, the level of Lp-PLA2 was AMIUAPSAP.5, from high to low. On the 4th day after PCI, the levels of Lp-PLA2 in the three groups were different among different types of coronary heart disease (CAD). By pairwise comparison, the Lp-PLA2 levels were arranged smoothly according to AMIUAPSAP. Conclusion: Lp-PLA2, as a strong vascular pro-inflammatory factor, can evaluate the activity of coronary artery disease, is an index to evaluate the severity of coronary artery disease, and can be used as an index to judge the possibility of coronary restenosis in patients with three different types of coronary heart disease after PCI. There are obvious differences in Lp-PLA2 level among different TCM syndrome differentiation patients of coronary heart disease after PCI, which can provide objective basis for TCM syndrome differentiation of coronary heart disease, guide the clinical use of traditional Chinese medicine for coronary heart disease, and can also be used as an objective index to judge which TCM syndrome type of coronary heart disease patients have greater possibility of recurrent stenosis after PCI.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4
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