慢性心衰患者辨证分型与神经内分泌激活关系研究  

Study on Relationship between Syndrome Differentiation and Neuroendocrine Activation in Patients with Chronic Heart Failure

作　　者：孙静[1] 刘克锋[1] 谭勇文[1] 刘培中[1] 杨华伟[1] 陈林榕[1] 李创鹏[1] 彭敏[1] 张艳玲[1] 

机构地区：[1]广东省中医院珠海医院,广东珠海519000

出　　处：《辽宁中医药大学学报》2015年第2期106-108,共3页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广东省中医药局项目(20121052)

摘　　要：目的:观察慢性心力衰竭患者(CHF)中医辨证分型与神经内分泌激活的关系。方法:对60例CHF患者进行辨证分型并获取中医症候积分、纽约心功能分级(NYHA)、左室射血分数(LVEF%),以B型钠尿肽(BNP)及肾素(PRA)-血管紧张素(AT)-醛固酮(ALD)系统(RAAS)水平作为神经内分泌激活指标,探讨不同证型、性别、心功能分级与神经内分泌激活的关系,探讨LVEF值与神经内分泌激活指标、BNP与RAAS各指标的相关性。结果:60例CHF患者中,均有气(阳)虚证,其中同时夹血瘀、痰饮证者48例,仅夹血瘀证者2例,仅夹痰饮证者10例。在神经内分泌指标激活程度的比较中,不同证型、性别间差异无显著性意义(P>0.05);不同心功能分级间,除PRA外,差异均有显著性意义(P<0.05)。相关性分析发现,LVEF值与除PRA外的神经内分泌激活指标呈负相关,均有显著性意义(P<0.05);而BNP与RAAS各指标间均呈正相关,均有显著性意义(P<0.05)。结论:慢性心衰患者中神经内分泌激活程度在不同辨证分型、性别中无明显差异,与心功能分级、LVEF值有关,且神经内分泌各指标激活程度呈一致性。Objective：To observe the relationship between syndrome differentiation of traditional Chinese medicine and activation of neuroendocrine index in patients with chronic heart failure（CHF）. Methods：Among the 60 patients with CHF,the syndrome differentiation and syndrome scores of TCM,New York heart function assessment（NYHA）,left ventricular ejective fraction（LVEF%）were obtained. BNP and renin-angiotensin-aldosterone system（RAAS）level were as the neuroendocrine activation index to discuss the relationship between different types,genders and grade of NYHA and neuroendocrine activation. We explored the correlation between LVEF and neuroendocrine activation index,BNP and RAAS. Results：Qi（Yang）deficiency syndrome was among 60 patients with CHF,48 cases with the blood stasis syndrome,phlegm and fluid syndrome at the same time,2 cases with blood stasis syndrome only,10 cases with phlegm and fluid syndromeonly. In comparison with the degree of activation of neuroendocrine index,there was no significant difference in syndrome differentiation or gender（P〈0.05）. In comparison with different grades of NYHA,except PRA,the differences were significant（P〉0.05）. Through the correlation analysis,LVEF was negatively correlated with the neuroendocrine activation index except PRA and the differences were significant（P〈0.05）while BNP was positively correlated with RAAS index and there were statistical significance（P〈0.05）. Conclusion：The degree of neuroendocrine activation in patients with chronic heart failure was not evident among the different syndrome differentiations,genders and grades and was related to grade of NYHA and LVEF and each index activation was consistent.

关 键 词：慢性心力衰竭 辨证分型 B型钠尿肽 肾素-血管紧张素-醛固酮系统 

分 类 号：R541.6[医药卫生—心血管疾病]