稳定性心绞痛中医证型与血小板活化及血流动力学的相关性研究  

Relationship between types of TCM syndrome and platelet activation and blood rheology in stable angina pectoris

作　　者：闫晓霞[1] 王建昌[1] 刘丽芳[1] 李忠东[2] 马建伟[3] 

机构地区：[1]空军总医院干部病房,北京100142 [2]空军总医院药剂科,北京100142 [3]空军总医院中医科,北京100142

出　　处：《中华保健医学杂志》2011年第6期450-452,共3页Chinese Journal of Health Care and Medicine

基　　金：首都医学发展基金项目(SF-2007-Ⅱ-06)

摘　　要：目的探讨稳定性心绞痛(SAP)中医证型与血小板聚集率(PAG)、P选择素(CD62P)、血小板膜糖蛋白Ⅱb/Ⅲa复合物(GPⅡb/Ⅲa)及血流动力学的关系。方法选择76例SAP患者,按中医证型分为心血瘀阻、气虚血瘀、气滞血瘀3种中医证型,分别用血小板聚集仪、流式细胞仪、血液黏度仪测定PAG、CD62P、GPⅡb/Ⅲa及血流动力学指标,并对3种中医证型的临床表现进行比较。结果心血瘀阻型GPⅡb/Ⅲa水平高于气虚血瘀型(P<0.05);与气滞血瘀型相比,气虚血瘀型全血黏度水平升高(P<0.05),而红细胞聚集指数降低(P<0.05);3种中医证型间CD62P、PAG比较,差异无统计学意义(P>0.05)。结论心血瘀阻型以GPⅡb/Ⅲa升高为主,而气虚血瘀型与气滞血瘀型则分别以全血黏度升高、红细胞聚集指数升高为特征。GPⅡb/Ⅲa、血流动力学可作为SAP微观辨证和疗效评定的参考指标,且对活血化瘀中成药的合理使用具有指导意义。Objective To explore the relationship between types of traditional chinese medical（TCM） syndromes and platelet aggregation（PAG）,P-selection（CD62P）,platelet membrane glycoprotein Ⅱb/Ⅲa complex（GPⅡb/Ⅲa）,blood rheology in patients with stable angina pectoris（SAP）.Methods Seventy-six patients with SAP were divided into 3 groups according to syndrome differentiation：cardiac blood stasis group,deficiency of vital energy and blood stasis group,qi-stagnancy and blood stasis group.Platelet aggregation was detected by instrument of platelet aggregation,and flow cytometry was used to measure CD62P and GPⅡb/Ⅲa,and blood rheology was detected by instrument of blood viscosity.Results The level of GPⅡb/Ⅲa was higher in cardiac blood stasis group than deficiency of vital energy and blood stasis group（P0.05）,but no difference than qi-stagnancy and blood stasis group.Compared with qi-stagnancy and blood stasis group,whole blood rheology was significantly higher in deficiency of vital energy and blood stasis group（P0.05）,but erythrocyte aggregation index was lower（P0.05）.There was no significant difference among 3 groups in PAG,CD62P（P0.05）.Conclusions The level of GPⅡb/Ⅲa in the group of cardiac blood stasis was higher.There were significant increases in whole blood viscosity and erythrocyte aggregation index respectively in deficiency of vital energy and blood stasis group and qi-stagnancy and blood stasis group.GPⅡb/Ⅲa and blood rheology may be an index of TCM syndrome differentiation and the estimation of therapeutic effect.They also may be applied to guide the treatment of SAP.

关 键 词：稳定性心绞痛 中医证型 血小板聚集率 P选择素 血小板膜糖蛋白Ⅱb/Ⅲa复合物 血流动力学 

分 类 号：R541.4[医药卫生—心血管疾病]