高密度脂蛋白磷脂对冠心病肾阳虚证的诊断作用  

Diagnosis value of high density lipoprotein phospholipids on coronary heart disease of kidney-Yang deficiency syndrome

作　　者：郭平清[1] 林求诚[2] 郭银庚[2] 沈宗国[2] 

机构地区：[1]福建医科大学附属第一医院,福建福州350005 [2]福建中医学院,福建福州350003

出　　处：《中国中西医结合急救杂志》2003年第4期223-225,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：福建省教委科研课题 (K90 0 45 )

摘　　要：目的 :寻找冠心病肾阳虚证新的生化诊断指标。方法 :6 1例冠心病患者根据中医辨证分为 3组 :无心气虚组 10例 ;心气虚不合并肾阳虚组 2 5例 ;心气虚合并肾阳虚组 2 6例。分别同步测定其 2 4 h尿 17羟皮质类固醇 (简称尿 17羟 )、血清高密度脂蛋白胆固醇 (HDL C)及高密度脂蛋白磷脂 (HDL PL ) ,并与 2 3名健康老年人进行对照。以 2 4 h尿 17羟低下作为肾阳虚证诊断标准筛选肾阳虚证新指标并给予初步的诊断学评价。结果 :2 6例冠心病肾阳虚证患者 HDL PL 为 (6 16± 15 7) mg/ L,明显低于无心气虚组 (911± 189) m g/ L 和心气虚不合并肾阳虚组 (76 3± 16 7) mg/ L。以低 HDL PL 血症 (HDL PL <6 5 0 m g/ L)诊断冠心病肾阳虚证 ,其敏感性为 73% ,特异性为 86 % ,准确性为 80 %。结论 :HDL PL <6 5 0 mg/ LObjective: To look for a new biochemical index for diagnosis of coronary heart disease (CHD) of kidney-Yang deficiency (KYD,) syndrome. Methods: Sixty-one patients with CHD were divided into three groups according to their traditional Chinese medicine(TCM) syndrome differentiation, 10 patients in the group without heart-Qi deficiency(HQD, group A),25 patients in the group with HQD but without KYD (group B) and 26 patients in the group both with HQD and KYD (group C).Levels of 17- hydroxy -corticosteroid in urine(17-OHCS) per 24 hours, serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipids (HDL-PL) were determined in synchronization and compared with those in the control group of 23 healthy aged persons. 17-OHCS per 24 hours was taken as the diagnostic standard to screen a new index for diagnosis of KYD syndrome,and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-KYD patients (group C) was (616± 157)mg/L , which was obviously lower than that in the patients of group A(911±189)mg/L and B(763± 167)mg/L . With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-KYD,the sensitivity was 73 percent, the specificity was 86 percent and the accuracy was 80 percent. Conclusion: HDL-PL<650 mg/L could be adopted as an index for CHD-KYD diagnosis,which is simple and practical.

关 键 词：高密度脂蛋白磷脂 冠心病 肾阳虚证 诊断 中医证型 血清 

分 类 号：R259[医药卫生—中西医结合]