冠心病痰瘀辨证与血清炎症因子关系的临床研究  

Study on the Relationship between Syndrome Differentiation of Phlegm and Blood Stasis and the Levels of Serum Inflammatory Cytokines in Coronary Heart Disease

作　　者：华军益[1] 刘艳[1] 王坤根[1] 毛威[1] 叶武[1] 蔡宏文[1] 陈杰[2] 陈隽妍[2] 许志良[3] 

机构地区：[1]浙江中医药大学附属第一临床医学院/浙江省中医院心内科,杭州310006 [2]浙江中医药大学 [3]浙江中医药大学附属第一临床医学院/浙江省中医院检验科,杭州310006

出　　处：《医学研究杂志》2008年第3期112-114,共3页Journal of Medical Research

基　　金：浙江省科技厅医药卫生科学研究基金(2005A072)

摘　　要：目的探讨冠心病(胸痹)痰瘀辨证与炎症因子单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP-9)、可溶性细胞间黏附分子-1(sICAM-1)表达的关系。方法入选60例冠心病患者,随机分为非痰非瘀组(n=20),痰凝心脉组(n=20),痰瘀互结组(n=20),另选健康志愿者作为正常对照(n=20),ELISA法测血清MCP-1、MMP-9、sICAM-1水平。结果与正常对照组比,非痰非瘀组、痰凝心脉组和痰瘀互结组患者血清MCP-1、MMP-9、sICAM-1水平均升高(P<0.05或P<0.01);与非痰非瘀组比较,痰凝心脉组及痰瘀互结组患者血清MMP-9、MCP-1水平逐渐升高(P<0.05或P<0.01),且二者之间的差异具有统计学意义(P<0.05),而sCD40L水平略高于非痰非瘀组但差异没有统计学意义(P>0.05),且两组间的差异亦没有统计学意义(P>0.05)。相关性分析可见,血清MCP-1和MMP-9水平与冠心病痰瘀辩证之间具有相关性(P<0.05或P<0.01)。结论血清炎症因子MMP-9和MCP-1水平可为冠心病痰瘀辨证分型提供客观依据。Objective To explore the relationship between syndrome differentiation of phlegm and blood stasis of coronary heart disease and the levels of monocyte chemoattractant protein - 1 （ MCP - 1 ）, matrix metalloproteinase - 9 （ MMP - 9 ） and soluble intercellular adhesion molecule - 1 （ sICAM - 1 ）. Methods Sixty patients with coronary heaart disease were evenly divided into three groups randomly ： the non - phlegm and non - stasis group（ n = 20） , the congealing phlegm of heart vessels group（ n = 20） and the intermingled phlegm and blood stasis group（n =20）. Twenty healthy volunteers was as the control group（n =20）. The levels of MCP - 1, MMP -9 and sICAM - 1 were determined by ELISA. Observe the differences within groups. Results The levels of serum MCP - 1, MMP - 9 and sICAM -1 showed higher in the non -phlegm and non -stasis group, the congealing phlegm of heart vessels group and the intermingled phlegm and blood stasis group than those of the control group （P 〈 0.05 or P 〈 0.01 ）. Compared with the non -phlegm and non- stasis group, patients in the congealing phlegm of heart vessels group and the intermingled phlegm and blood stasis group have higher levels of MCP - 1 and MMP - 9 （ P 〈 0.05 or P 〈 0.01 ）, and there was statistics significance between the two groups （ P 〈 0.05 ）. It showed the level of serum MCP - 1 and MMP - 9 were related with syndrom differentiation of phlegm and blood stasis in coronary heart disease patients. Conclusions Syndrom differentiation of phlegm and blood stasis in coronary heart disease may be according to the levels of serum MMP-9 and MCP-1.

关 键 词：冠心病 痰瘀辨证 单核细胞趋化蛋白-1 基质金属蛋白酶-9 可溶性细胞间黏附分子-1 

分 类 号：R541.4[医药卫生—心血管疾病] R2-031[医药卫生—内科学]