急性冠状动脉综合征同病异证与一氧化氮、内皮素-1、血管紧张素转化酶水平相关性的研究  

Comparative analysis on the level of nitric oxide,endothelin-1,angiotensin converting enzyme of different patterns in the same disease in patients with acute coronary syndromes

作　　者：许振业 柳景华[1] 刘建勋[2] 王韶屏[1] 任钧国[2] 程姝娟[1] 贾敏[2] 马彩云[3] 吕媛[1] 吴铮[1] 彭红玉[1] 赵烨婧 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [2]中国中医科学院西苑医院 [3]中国医科大学航空总医院

出　　处：《心肺血管病杂志》2017年第10期800-803,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点基础研究发展计划(973计划)(2015CB554404);国家自然科学基金(81570388)

摘　　要：目的:探讨急性冠状动脉综合征(ACS)拟行经皮冠状动脉介入治疗(PCI)的患者气滞血瘀证、气虚血瘀证血清一氧化氮(NO)、内皮素-1(ET-1)、血管紧张素转化酶(ACE)水平变化及与冠状动脉病变程度的相关性。方法:选取于首都医科大学附属北京安贞医院住院,临床诊断为ACS并经皮冠状动脉造影术证实为冠心病拟行PCI治疗的患者60例,分成气滞血瘀证、气虚血瘀证两组,分别检测血清NO、ET-1、ACE水平变化,并对患者进行血瘀证计分、冠状动脉病变程度评分(Gensini评分)。结果:在ACS气病致瘀的病理过程中,血清NO水平气虚血瘀证组较气滞血瘀证组明显升高(P=0.014)。ACS血瘀证患者,NO水平与Gensini评分无相关性(r=-0.065,P=0.624);ET-1水平与Gensini评分存在负相关,但相关性较弱(r=-0.303,P=0.020);ACE水平与Gensini评分无相关性(r=-0.015,P=0.912);血瘀证总分与Gensini评分无相关性(r=0.072,P=0.590),血瘀证各项计分与Gensini评分均无相关性。结论:血清NO可考虑作为ACS气滞血瘀证、气虚血瘀中医辩证分型的生物学标志物。ET-1与Gensini评分存在极弱负相关,不能独立做为评估冠状动脉严重程度的临床检测指标。Objective： To explore the level of NO, ET-1, ACE differences between qi-stagnation and qi-deficiency induced blood-stasis syndrome and relationship between the indicators and the degree of coronary artery lesion in patients with acute coronary syndromes （ACS）. Methods： Sixty ACS patients were divided into two groups： qi-stagnation and qi-deficiency induced blood-stasis syndrome group and analyzed the difference of the level of NO, ET-1, ACE, blood-stasis syndrome score, coronary artery lesion score （ Gensini score） of different types. Results： The level of NO, qi-deficiency induced blood-stasis syndrome group were higher than that of qi-stagnation induced blood-stasis syndrome group （P = 0. 014）. There was certain correlation between endothelin-1 and Gensini seore（r = -0. 303 ,P = 0. 020）in ACS patients with blood stasis syndrome. Conclusion： NO can served as biological markers of blood-stasis syndrome. ET-1 can not be used as a clinical index to evaluate coronary artery severity independently.

关 键 词：冠心病 一氧化氮 内皮素-1 血管紧张素转化酶 气滞血瘀证 气虚血瘀证 

分 类 号：R54[医药卫生—心血管疾病]