冠心病血瘀证患者血浆和单核细胞水平凝血/纤溶活性研究  

Study on Blood Coagulant/Fibrinolytic Activity at Plasma and Monocytic Levels in Coronary Heart Disease Patients with Blood-Stasis Syndrome of Traditional Chinese Medicine

作　　者：吕中 施赛珠[2] 

机构地区：[1]浙江中医学院附属第二医院,杭州310007 [2]上海医科大学附属华山医院

出　　处：《中国中西医结合杂志》2000年第6期418-420,共3页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的：研究并比较冠心病血瘀证患者血浆和单核细胞水平凝血／纤溶活性的改变及其意义。方法：80例冠心病患者分为血瘀证组30例和非血瘀证组50例（包括痰浊型27例，气滞型23例），另设健康对照组20名；采用发色底物法分别检测血浆和外周血单核细胞（PBMC）组织型纤溶酶原激活物（t－PA）及其抑制物（PAI－1）活性，并检测PBMC促凝活性（PCA）。结果：冠心病血瘀证患者血浆PAI-1活性和PBMCPCA显著高于非血瘀证组和健康对照组（P＜0．01）；血瘀证和非血瘀证患者PBMCPAI－1活性无显著性差异（P＞0．05），但均高于健康对照组（P＜0．01）；血瘀证患者血浆t－PA活性与非血瘀证患者无显著性差异（P＞0．05），PBMCt－PA活性血瘀证组显著低于非血瘀证组及健康对照组（P＜0．01）。结论：冠心病血瘀证患者单核细胞促凝活性增高，并在血浆和单核细胞两水平上纤溶活性降低，上述凝血／纤溶活性改变可能是血瘀证形成的重要病理因素，提示冠心病血瘀证患者处于血栓前状态。Objective: To explore and compare the changes of coagulant/fibrinolytic activity in coronary heart disease (CHD) patients with Blood Stasis Syndrome of TCM and evaluate the roles of these changes. Methods: Eighty patients of CHD were divided into two groups by Syndrome Differentiation of TCM, the Blood-Stasis (BS) group (30 cases) and the non-Blood-Stasis (NBS) group (50 cases, including 27 cases of Phlegm-Dampness Syndrome and 23 cases of Q1-Stagnation Syndrome); and 20 healthy persons were enrolled as normal control group. Tissue type plasminogen activator (t-PA) and its inhibitor (PAI-1) in pIasma and in human peripheral blood monocyte cell (PBMC), as well as the procoagulant activity (PCA) in PBMC were measured by chro mogenic substrate method. Results: The plasma PAI-1 activity and PCA of PBMC in the BS group were signifi cantly higher than those in the NBS group and the normal control group (P < 0. 01). PAI-1 activity of PBMC in the two groups of CHD patients was higher than those in the normal control group significantly (P < 0. 01), but no significant difference was found between the BS group and the NBS group (P > 0. 05). The difference of plasma t-PA activity between the two groups of CHD was insignificant. The PBMC t-PA activity in the BS group was lower than that in the NBS and normal control groups (P < 0. 01 ). Conclusion: In the CHD patients with BS, the PBMC PCA was increased and the fibrinolytic activity at both plasma and monocyte levels lowered significantly, these changes in coagulant/fibrinolytic activity may be the important pathologic factors in forming BS which suggests that CHD patients with BS were in the prothrombotic state.

关 键 词：冠心病 血瘀证 单核细胞 血浆 凝血/纤溶活性 

分 类 号：R259[医药卫生—中西医结合]