急性心肌梗死患者不同中医体质与血清Lp-PLA2、sd-LDL-C、Hcy及冠脉病变程度的相关性研究  

Study on Relationship of Different Constitutions of TCM and Serum Lp-PLA2,sd-LDL-C,Hcy and Degree of Coronary Artery Lesion in Patients with AMI

作　　者：张云丽 宋囡[1] 严峰 朱敬轩 陈文娜[3] ZHANG Yunli;SONG Nan;YAN Feng;ZHU Jingxuan;CHEN Wenna(Graduate School,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Department of Laboratory Medicine,The People's Hospital of China Medical University,The People's Hospital of Liaoning Province,Shenyang 110016,Liaoning,China;School of Medical Laboratory,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学研究生学院,辽宁沈阳110847 [2]辽宁省人民医院暨中国医科大学人民医院检验医学科,辽宁沈阳110016 [3]辽宁中医药大学医学检验学院,辽宁沈阳110847

出　　处：《辽宁中医杂志》2024年第5期71-75,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81874372)

摘　　要：目的 探讨血清脂蛋白相关磷脂酶A2(serum lipoprotein-associated phospholipase A2,Lp-PLA2)、小而密低密度脂蛋白胆固醇(small dense low density lipoprotein, sd-LDL-C)、同型半胱氨酸(homocysteine, Hcy)及冠脉病变程度与急性心肌梗死(acute myocardial infarction, AMI)患者不同中医体质之间的关系。方法 以2022年5月—2022年7月在辽宁省人民医院就诊的172例AMI患者为病例组,同期168例健康体检者为对照组,通过调查问卷的方式将病例组按照中医体质进行分组,比较不同分组患者的一般特征信息及Lp-PLA2、sd-LDL-C、Hcy、Cys-C、LP(a)、血脂项目水平及病变支数、Gensini评分。结果 (1)病例组首要中医体质分布情况:气虚质>血瘀质>痰湿质>平和质>阳虚质>阴虚质>气郁质。(2)病例组与研究组一般特征比较:年龄差异无统计学意义(P>0.05),病例组的男性比率、BMI、有吸烟史、饮酒史、糖尿病史、高血压病史及家族史的人员比率较高(P<0.05)。(3)病例组与对照组的血清检测结果比较:病例组的Lp-PLA2、Hcy、Hs-CRP、Cys-C、LP(a)结果高于对照组,HDL-C结果低于对照组(P<0.05)。Lp-PLA2、Hcy、TC及LDL-C水平:血瘀质>痰湿质>气虚质及平和质;sd-LDL-C及TG水平:痰湿质>血瘀质>气虚质及平和质;Hs-CRP及Cys-C水平:血瘀质>气虚质>痰湿质及平和质;HDL-C水平:痰湿质<血瘀质。(4)病例组不同中医体质与冠脉病变程度的相关性:平和质轻于其他中医体质。结论 Lp-PLA2、sd-LDL-C及Hcy等检测结果水平及冠状动脉血管病变程度在不同中医体质的AMI患者血清中存在差异性,检测Lp-PLA2、sd-LDL-C及Hcy水平有利于临床医生进行中医辨证治疗。Objective To investigate the relationship of serum lipoprotein-associated phospholipase A2(Lp-PLA2),small dense low density lipoprotein(sd-LDL-C),homocysteine(Hcy),the severity of coronary artery disease and different traditional Chinese medicine(TCM)constitutions in patients with acute myocardial infarction(AMI).Methods A total of 172 patients with AMI admitted to the People's Hospital of Liaoning Province from May to July in 2022 were selected as the case group,and 168 healthy persons as the control group.The case group was divided into groups according to the constitutions of TCM by means of questionnaire,the general characteristics,Lp-PLA2,sd-LDL-C,Hcy,cystatin C(Cys-C),lipoprotein a[LP(a)],serum lipids,number of diseased vessels and Gensini score were compared among different groups.Results 1.In the case group,the main constitution of TCM was Qi deficiency>blood stasis>phlegm-dampness>gentle type>Yang deficiency>Yin deficiency>Qi depression.2.There was no difference in age(P>0.05).The ratio of male,body mass index(BMI),smoking,drinking,diabetes,hypertension and family history were higher in the case group(P<0.05).3.The serum levels of Lp-PLA2,Hcy,hypersensitive C-reactive protein(hs-CRP),Cys-C and LP(a)were higher in the case group than those in the control group,while the serum levels of high-density lipoprotein cholesterol(HDL-C)were lower in the case group than those in the control group(P<0.05).The levels of Lp-PLA2,Hcy,total cholesterol(TC)and LDL-C:Blood stasis>phlegm-dampness>Qi deficiency and gentle type.The levels of sd-LDL-C and TG:phlegm-dampness>blood Stasis>Qi deficiency and gentle type.The levels of hs-CRP and Cys-C:blood stasis>Qi deficiency>phlegm-dampness and gentle type.HDL-C level:phlegm-dampness<blood stasis.4.The correlation of the different constitutions of TCM and the degree of coronary artery lesion in the case group:the constitution of gentle type was lighter than that of other constitutions of TCM.Conclusion The levels of Lp-PLA2,sd-LDL-C and Hcy and the degree of coronary artery le

关 键 词：急性心肌梗死 中医体质 LP-PLA2 sd-LDL-C HCY 冠脉病变程度 

分 类 号：R256.21[医药卫生—中医内科学]