急性冠脉综合征同病异证与TM、ICAM-1、Lp-PLA2水平的相关性研究  

Correlation Research on Levels of TM,ICAM-1,Lp-PLA2 and Different Syndrome Patterns In Patients with Acute Coronary Syndrome

作　　者：许振业 柳景华[1] 刘建勋[3] 王韶屏[1] 任钧国[3] 程姝娟[1] 马彩云[4] 马芹[1] 吕媛[1] 吴铮[1] 彭红玉[1] 赵烨婧 XU Zhen-ye1, LIU Jing-hua1, LIU Jian-xun2, WANG Shao-ping1 , REN Jun-guo2, CHENG Shu-juan1 , MA Cai-yun3, MA Qin1 , LV Yuan1 , WU Zheng1 , PENG Hong-yu1 ,and ZHAO Ye-jing1(1 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing （100029）; 2 Institute of Basic Medical Sciences, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing （100091）; 3 Department of Cardiology, Aviation General Hospital, Beijing （100016）)

机构地区：[1]首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所,北京100029 [2]北京市大兴区人民医院心内科,北京102600 [3]中国中医科学院西苑医院基础医学研究所,北京100091 [4]中国医科大学航空总医院心内科,北京100012

出　　处：《中国中西医结合杂志》2018年第5期530-533,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家重点基础研究发展计划(No.2015CB554404); 国家自然科学基金资助项目(No.81570388)

摘　　要：目的比较急性冠脉综合征(ACS)气滞血瘀证、气虚血瘀证不同证型蛋白表达水平,为ACS辨证分型提供客观依据。方法 60例2015年7月—2016年2月于首都医科大学附属北京安贞医院心内科住院,临床诊断为ACS并经皮冠状动脉造影术证实为冠心病拟行经皮冠状动脉介入治疗的患者,其中气滞血瘀证组29例,气虚血瘀证组31例。检测血清高敏C反应蛋白(hs-CRP)、血清血栓调节蛋白(TM)、可溶性细胞间黏附分子(ICAM-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平变化,并记录血瘀证计分及冠脉病变程度评分(Gensini评分)。结果与气滞血瘀证组比较,气虚血瘀证组TM、ICAM-1水平升高(P=0.039,P=0.026);两组hs-CRP、Lp-PLA2水平、Gensini评分、血瘀证各项计分及总分比较差异均无统计学意义(均P>0.05)。ACS气滞血瘀及气虚血瘀证患者hs-CRP、TM、ICAM-1、Lp-PLA2水平及血瘀证总计分均与Gensini评分无相关性(P>0.05)。结论血清TM、ICAM-1可考虑作为ACS患者气滞血瘀证、气虚血瘀辨证分型的生物学标志物。Objective To provide an objective basis for syndrome differentiation of acute coronary syndromes（ACS）,and to analyze the differences in expression of different proteins in qi stagnation induced blood stasis syndrome（QSBS） and qi deficiency induced blood stasis syndrome（QDBS）. Methods Totally 6 0 patients who were hospitalized in department of cardiology,Beijing Anzhen Hospital, Capital Medical University from July 2015 to February 2016, were diagnosed as ACS and confirmed by percutaneous coronary angiography as coronary artery coronary intervention. There were 2 9 cases with QSBS,and 3 1 cases with QDBS. The changes of serum high sensitive C reactive protein（ hs-C RP）,serum thrombomodulin（TM）,soluble in tercellular adhesion molecule（ ICAM-1） and lipoprotein related phospholipase A2（ Lp-PLA2）were detected,and the score of blood stasis syndrome and the degree of coronary artery disease（ Gensini score）were recorded. Results Com pared with the qi stagnation induced blood stasis syndrome group,the levels of TMand ICAM-1 in the QDBS group increased（P = 0.039,P=0.026）. There was no significant difference in the levels of hs-CRP, Lp-PLA2,Gensini score and blood stasis syndrome score（all P〈0.05）. The levels of hs-CRP, TM, ICAM-1, Lp-PLA2 and the total score of blood stasis syndrome in patients with QSBS and QDBS were not correlated with the Gensini score. Conclusion The levels of TMand ICAM-1 could be the biomarkers of QSBS and QDBS.

关 键 词：冠心病 气滞血瘀证 气虚血瘀证 血栓调节蛋白 可溶性细胞间黏附分子 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]