冠心病患者血瘀证积分联合超敏C反应蛋白对动脉粥样硬化斑块性质的初步评价  

Combined blood stasis syndrome scores and hs-CRP in evaluation of AS plague characteristics in patients with coronary heart diseases

作　　者：彭春丽[1] 梁东辉[1] 黄曾艳 刘永源[2] 黄曼萍[2] 张慧杰 江宇宁 

机构地区：[1]南方医科大学中医药学院,广东广州510515 [2]南方医科大学珠江医院中医科,广东广州510280

出　　处：《广东医学》2018年第1期143-147,共5页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81072935);广东省自然科学基金资助项目(编号:S2013010015883);广州市科技计划项目(编号:201609010044)

摘　　要：目的探讨冠心病患者血瘀证积分联合超敏C反应蛋白(hs-CRP)对动脉粥样硬化(AS)斑块性质的评估价值。方法入选96例冠心病(CHD)患者,其中急性冠脉综合征(ACS)患者53例,稳定型心绞痛(SAP)患者43例,根据多层螺旋CT冠脉成像结果将CHD患者分为非钙化斑块组(37例)、混合斑块组(31例)、钙化斑块组(28例)。采集各组基本临床资料,计算血瘀证积分,检测患者血清hs-CRP浓度及相关血液生化指标。结果 (1)非钙化斑块组hs-CRP浓度及血瘀证积分高于混合斑块组及钙化斑块组,混合斑块组高于钙化斑块组,差异均有统计学意义(P<0.05)。(2)非钙化斑块组及混合斑块组hs-CRP浓度与血瘀证积分呈正相关(r=0.680,P<0.001;r=0.577,P=0.001)。(3)ACS患者斑块分布主要以非钙化斑块及混合斑块为主,SAP患者以钙化斑块为主,差异有统计学意义(P<0.05)。(4)ACS患者hs-CRP浓度及血瘀证积分高于SAP患者,差异有统计学意义(P<0.05)。结论冠心病患者hs-CRP浓度、血瘀证积分与AS斑块性质密切相关,且hs-CRP与血瘀证积分在非钙化斑块组及混合斑块组中呈正相关,提示联合两者可能有助于评估斑块稳定性。Objective To elvaluate the value of the combination of blood stasis syndrome scores and serum of high - sensitivity C - reactive protein （ hs - CRP） in evaluation of atherosclerosis （AS） plaques characteristics for patients with coronary heart diseases （CHD）. Methods Ninety - six patients with CHD was enrolled, among whom 53 patients were diagnosed as acute coronary syndromes （ACS） and the other 43 patients were diagnosed as stable angina pectoris （SAP）. Base on coronary computed tomographic angiography （CCTA）, all patients were divided into non- calcified plaque group （37 cases）, mixed plaque group （31 cases） and calcified plaque group （28 cases）. In each group, general clinical data, blood stasis syndrome scores, serum levels of hs - CRP, as well as blood biochemical report were recorded. Results The hs - CRP level and blood stasis syndrome scores were significantly higher in non - calcified plaque group than those in mixed plaque group and calcified plaque group （P 〈0. 05 ）. Moreover, hs -CRP and blood stasis syndrome scores in mixed plaque group were significantly higher than in calcified plaque group （ P 〈 0. 05 ）. In non - calcified plaque group and mixed plaque group, the hs - CRP level and blood stasis syndrome scores were significantly positively correlated （ r = 0. 680, P 〈 0. 001 ; r = 0. 577, P = 0. 001 ）. Non - calcified plaque and mixed plaque were the major types in the ACS patients, while calcified plaque was the major plaque type in the SAP patients （ P 〈 0. 05 ）. The blood stasis syndrome scores and hs - CRP level were significantly higher in patients with ACS than those in patients with SAP （P 〈 0.05）. Conclusion The level of hs - CRP and blood stasis syndrome scores are positively correlated in non - calcified plaque group and mixed plaque group, and associated with AS plaques characteristics. It might be useful in the evaluation of plaque stability in CHD patients by combining hs - CRP and blood stasis syndrome scores.

关 键 词：冠状动脉病变 动脉粥样硬化斑块 血瘀证积分 超敏C反应蛋白 

分 类 号：R259[医药卫生—中西医结合]