不同中医证型急性冠脉综合征患者血管内皮功能、Th17/Treg水平及预后分析  

Analysis of vascular endothelial function,Th17/Treg levels and prognosis of patients with acute coronary syndrome in different Chinese medicine certificates

作　　者：丁晨 谢娇 雷燕 DING Chen;XIE Jiao;LEI Yan(Department of Pharmacy,The Nuclear Industry 417Hospital,Xian Shaanxi 710600,China;Department of Pharmacy,The Second Affiliated Hospital of Xian Jiaotong University,Xian Shaanxi 710004,China;The Third Department of Internal Medicine,Jingbian County Peoples Hospital,Jingbian Shaanxi 718500,China)

机构地区：[1]核工业四一七医院药剂科,陕西西安710600 [2]西安交通大学第二附属医院药剂科,陕西西安710004 [3]靖边县人民医院消化内科,陕西靖边718500

出　　处：《四川中医》2024年第12期9-11,共3页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:分析不同中医证型急性冠脉综合征(ACS)患者的血管内皮功能、辅助性T细胞17(Th17)/调节性T细胞(Treg)水平及预后。方法:纳入2022年1月~2023年3月在本院接受治疗的114例ACS患者,根据不同中医证型分为气虚血瘀、气阴两虚、痰瘀互阻,另纳入同期进行健康体检的33名体检者为对照组,检测对比不同中医证型ACS患者、对照组的内皮功能[血管内皮生长因子(VEGF)、内皮素-1(ET-1)]、Th17比例、Treg比例及Th17/Treg比值。对ACS患者进行一年随访,统计对比不同中医证型ACS患者的心血管主要不良事件(MACE)情况。结果:114例ACS患者中气虚血瘀31例、气阴两虚34例、痰瘀互阻49例。各中医证型ACS患者的ET-1、Th17比例、Treg比例及Th17/Treg均高于对照组,而VEGF均低于对照组(P<0.05)。与气阴两虚、痰瘀互阻相比,气虚血瘀患者的ET-1、Th17比例、Treg比例及Th17/Treg均更高,VEGF均更低(P<0.05)。气虚血瘀患者的MACE发生率均高于气阴两虚、痰瘀互阻(P<0.05)。结论:ACS患者血管内皮功能降低、Th17/Treg水平升高,并以气虚血瘀表现更为明显,且该证型患者预后较差。Objective To analyze the vascular endothelial function,helper T-cell 17(Th17)/regulatory T-cell(Treg)levels and prognosis of patients with acute coronary syndrome(ACS)in different Chinese medicine certificates.Methods The 114ACS patients who received treatment in our hospital from January 2022to March 2023were included,and were categorized into qi deficiency and blood stasis,qi and yin deficiency,and phlegm and blood stasis mutual obstruction according to different Chinese medicine evidence types.Another 33medical examiners who underwent health checkups during the same period were included as the control group,and endothelial function[vascular endothelial growth factor(VEGF),endothelin-1(ET-1)],Th17ratio,Treg ratio,and Th17/Treg ratio were detected and compared between patients with different Chinese medicine certificates of ACS,and the control group.The ACS patients were followed up for one year,and the major adverse cardiovascular events(MACE)of ACS patients with different TCM certificates were statistically compared.Results Among the 114ACS patients,there were 31cases of qi deficiency and blood stasis,34cases of qi and yin deficiency,and 49cases of phlegm and stasis mutual obstruction.ET-1,Th17ratio,Treg ratio and Th17/Treg were higher than those of the control group in ACS patients of all TCM evidence types,while VEGF was lower than those of the control group(P<0.05).Compared with qi and yin deficiency and phlegm and stasis mutual obstruction,patients with qi deficiency and blood stasis had higher ET-1,Th17ratio,Treg ratio and Th17/Treg,and lower VEGF(P<0.05).The incidence of MACE in patients with qi deficiency and blood stasis were all higher than those with qi and yin deficiency and phlegm and stasis mutual obstruction(P<0.05).Conclusion Patients with ACS have reduced vascular endothelial function,elevated Th17/Treg levels,and more pronounced manifestations of qi deficiency and blood stasis,and patients with this syndrome have a poorer prognosis.

关 键 词：中医证型 急性冠脉综合征 血管内皮功能 辅助性T细胞17/调节性T细胞 预后 

分 类 号：R543.8[医药卫生—心血管疾病]