痰浊阻遏证及脾肾阳虚证血脂异常患者椎、基底动脉血流动力学特点及其与ONOO^-浓度间的相关性研究  

Study on hemodynamic characteristics of vertebral and basilar arteries and their correlation with ONOO^- concentration in patients with dyslipidemia of turbid phlegm obstruction syndrome and spleen-kidney yang deficiency syndrome

作　　者：陈婧 杨惠民[2] 叶超[3] 谭昕 李品慧 史永梅[4] 刘培燕[4] 杨正 薛晓琳 CHEN Jing;YANG Huimin;YE Chao(Center for Preventive Treatment of Disease,Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院治未病中心,100029 [2]北京中医药大学东直门医院脑三科 [3]北京中医药大学东直门医院骨二科 [4]北京中医药大学东直门医院TCD室 [5]辽宁中医药大学第一临床医学院心内科 [6]海南省中医院心内科 [7]北京中医药大学中医学院中医体质与生殖医学研究中心 [8]北京中医药大学中医学院中医诊断系

出　　处：《环球中医药》2019年第9期1323-1328,共6页Global Traditional Chinese Medicine

基　　金：中央高校基本科研业务费专项基金(2014-JYBZZ-XS-135);教育部资助北京中医药大学自主课题(2180072120002);北京中医药大学新奥奖励基金(2018-XAJLJJ-026)

摘　　要：目的探讨痰浊阻遏证及脾肾阳虚证血脂异常患者椎、基底动脉血流动力学特点及其与过氧亚硝基阴离子(peroxynitrite,ONOO-)浓度指标的关系。方法在符合血脂异常诊断标准的基础上,通过中医证候辨识标准判断患者证候,其中痰浊阻遏证20例、脾肾阳虚证23例。采用经颅多普勒超声(trancranial doppler,TCD)测定43例血脂异常患者椎、基底动脉血流动力学指标,包含血流速度[收缩期峰值血流速度(peak systolic velocity,PSV)、舒张末期血流速度(end diastolic velocity,EDV)和平均血流速度(mean flow velocity,MFV)]以及搏动指数(pulsatility index,PI)和阻力指数(resistance index,RI)等相关指标;采用酶联免疫吸附的方法检测ONOO-的浓度。结果椎动脉流速及基底动脉流速(PSV、EDV和MFV)脾肾阳虚证患者均快于痰浊阻遏证患者,其中左侧椎动脉的PSV、右侧椎动脉的MFV、PSV、EDV条目中有统计学意义(P<0.05)。脾肾阳虚证患者左侧椎动脉的MFV、PFV及EDV与ONOO-浓度成正相关(P<0.05);痰浊阻遏证患者双侧椎动脉、基底动脉结果、脾肾阳虚证患者基底动脉结果与ONOO-浓度的相关性不强。结论(1)从TCD指标上看,血脂异常患者不同证候间,椎动脉、基底动脉血流动力学指标部分指标可以反映证候的不同;(2)脾肾阳虚证血脂异常患者随着椎动脉流速的增快,可能出现由于ONOO-浓度随之升高所致的血管内皮损伤,可以通过TCD检查量化血流动力学指标,间接推测血管损伤的程度,为进一步治疗提供参考;(3)上述变化特点与不同证候间中医病因病机分析相一致,丰富中医辨证的内涵,为标准化、客观化辨证提供依据。Objective To explore hemodynamic characteristics of vertebral and basilar arteries and their relationship with peroxynitrite anion(ONOO^-)concentration in patients with dyslipidemia of turbid phlegm obstruction syndrome and spleen-kidney yang deficiency syndrome.Methods On the basis of meeting the diagnostic criteria of dyslipidemia,the syndrome of patients was judged by the criteria of syndrome differentiation in traditional Chinese medicine(TCM),including 20 cases of turbid phlegm obstruction syndrome and 23 cases of spleen-kidney yang deficiency syndrome.Transcranial Doppler(TCD)was used to measure hemodynamics indexes of vertebral and basilar arteries in 43 patients with dyslipidemia,including blood flow velocity[Peak Systolic Velocity(PSV),End Diastolic Velocity(EDV)and Mean Flow Velocity(MFV)],pulsatility index(PI),resistance index(RI),etc.The concentration of ONOO^-was detected by enzyme-linked immunosorbent assay.Results Vertebral artery flow velocity and basilar artery flow velocity(PSV,EDV and MFV)were faster in the patients with spleen-kidney yang deficiency syndrome than those in the patients with turbid phlegm obstruction syndrome.Among them,the PSV of the left vertebral artery,the MFV,PSV and EDV of the right vertebral artery were statistically significant(P<0.05).The MFV,PFV and EDV of the left vertebral artery in the patients with spleen-kidney yang deficiency syndrome were positively correlated with the ONOO^-concentration(P<0.05).The correlations between the ONOO^-concentration and the results of bilateral vertebral arteries and basilar artery in the patients with turbid phlegm obstruction syndrome,or the results of basilar artery(BA)in the patients with spleen-kidney yang deficiency syndrome were not strong.Conclusion(1)According to the TCD indexes,some hemodynamics indexes of vertebral artery and basilar artery can reflect different syndromes among dyslipidemia patients with different syndromes.(2)With the increase of vertebral artery flow velocity,patients with dyslipidemia of spleen-kidney y

关 键 词：血脂异常 证候 经颅多普勒 过氧亚硝基阴离子 

分 类 号：R259[医药卫生—中西医结合]