脂代谢对冠心病血瘀证不同胆固醇水平的研究  

The Impact of Lipid Metabolism on the Variation of Cholesterol Levels in Coronary Heart Disease with Blood Stasis Syndrome

作　　者：陈维鑫 崔悦欣 张省委 王琦[2] 马子坤[2] 徐杰[2] 韩冉[2] CHEN Weixin;CUI Yuexin;ZHANG Shengwei;WANG Qi;MA Zikun;XU Jie;HAN Ran(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《标记免疫分析与临床》2024年第10期1779-1786,共8页Labeled Immunoassays and Clinical Medicine

基　　金：北京中医药大学(编号:2019-JYB-JS-115)。

摘　　要：目的通过收集冠心病血瘀证患者的病历资料进行回顾性调查,以中医理论为指导,探讨分析血液检测指标Lp(a)、sdLDL、TG、C1q、CRP、Hcy、PDW、FIB、APTT、PT、TT对冠心病血瘀证患者CHO水平的相关影响。方法采用回顾性研究方法,选取2021年1月至2022年12月北京中医药大学东方医院住院部符合冠心病血瘀证诊断的患者,记录患者姓名、年龄、性别、既往史等一般资料以及各项血液检测指标。根据CHO中位数将患者分为低CHO组和高CHO组,通过统计学方法分析比较各项血液检测指标在高、低CHO两组之间的差异以及它们之间与冠心病的相关性。结果两组患者在年龄、性别、既往史、Lp(a)、CRP、PDW、FIB、APTT、TT方面差异均无统计学意义(P>0.05)。高CHO组sdLDL、TG、C1q水平均高于低CHO组,Hcy、PT水平均低于低CHO组,两组间差异均具有统计学意义(P<0.05)。二元Logistics回归模型显示sdLDL、TG、Hcy对冠心病血瘀证患者的CHO水平有显著影响(P<0.05)。经ROC曲线分析,差异性指标sdLDL、TG、C1q、Hcy、PT联合对冠心病血瘀证患者CHO水平升高的预测价值(AUC为0.873,灵敏度为91.7%,特异性为67.9%)大于sdLDL、TG、C1q、Hcy、PT单独的预测价值(P<0.05)。相关性指标sdLDL、TG、Hcy联合对冠心病血瘀证患者CHO水平升高的预测价值(AUC为0.871,灵敏度为89.3%,特异性为70.2%)大于sdLDL、TG、Hcy单独的预测价值(P<0.05)。结论不同CHO水平下的冠心病血瘀证患者在血液检测指标上存在显著差异,且血液指标联合检测对冠心病血瘀证患者CHO水平有较好的预测价值。Objective This study aimed to investigate the correlation between blood biomarkers including Lp(a),sdLDL,TG,C1q,CRP,Hcy,PDW,FIB,APTT,PT,and TT,and cholesterol(CHO)levels in patients with coronary heart disease(CHD)complicated by blood stasis syndrome(BSS),through a retrospective analysis of their medical records guided by traditional Chinese medicine(TCM)theories.Methods A retrospective study was conducted involving patients admitted to the Inpatient Department of Dongfang Hospital of Beijing University of Chinese Medicine,who were diagnosed with CHD-BSS between January,2021 and December,2022.General patient information such as name,age,gender,and past medical history,along with blood biomarker test data,were recorded.Patients were stratified into the low-CHO and high-CHO groups based on the median CHO level.Statistical analyses were performed to evaluate differences in blood biomarkers between the two groups and their associations with CHD.Results No statistically significant differences were observed between the two groups in terms of age,gender,past medical history,Lp(a),CRP,PDW,FIB,APTT,and TT(P>0.05).The high-CHO group exhibited significantly higher levels of sdLDL,TG,and C1q,and lower levels of Hcy and PT compared to the low-CHO group(P<0.05).Binary logistic regression analysis revealed that sdLDL,TG,and Hcy had significant impacts on CHO levels in CHD-BSS patients(P<0.05).ROC curve demonstrated that the combined predictive value of sdLDL,TG,C1q,Hcy,and PT for elevated CHO levels in CHD-BSS patients(AUC=0.873,sensitivity=91.7%,specificity=67.9%)surpassed that of any individual biomarker(P≤0.05).Similarly,the combined predictive value of sdLDL,TG,and Hcy(AUC=0.871,sensitivity 89.3%,specificity 70.2%)was superior to any single-biomarker test(P<0.05).Conclusion The current study indicates significant differences existing in blood biomarker profiles between CHD-BSS patients with varying CHO levels,and highlights the clinical potentials of combined biomarker detection in predicting CHO levels in this patient p

关 键 词：冠心病 血瘀证 脂代谢指标 胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]