心绞痛不同血瘀证型与冠心病危险因素及炎症因子相关性

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1、提要目的：分析冠心病心绞痛不同血瘀辨证分型的分布规律，探讨不同血瘀证型与冠心病危险因素及炎症指标的相关性，以及稳定型心绞痛与不稳定型心绞痛的差异性。方法：将150例冠心病心绞痛血瘀证患者根据四诊辨证分为气虚血瘀、痰浊血瘀、气滞血瘀、血虚血瘀、寒凝血瘀、热毒血瘀6种类型，采集患者临床资料，测定患者血清中炎症指标IL-6、Lp-PLA2，建立SPSS数据库，首先对整体资料进行基础资料、证型分析，然后对证型与冠心病危险因素及合并疾病之间进行了logistic回归分析；最后针对合并疾病与证候的相关性、证型与炎症

2、指标的相关性做了logistic回归或多元逐步回归分析。结果：冠心病心绞痛血瘀证不同证型中气虚血瘀、痰浊血瘀、血虚血瘀、气滞血瘀为心绞痛血瘀证的常见证型；气虚血瘀与Lp-PLA2、痰浊血瘀与BMI、血虚血瘀与糖尿病、热毒血瘀和吸烟、BMI等存在相关性：不稳定型心绞痛患者较稳定型心绞痛患者LDL、Hs-CRP、IL-6、Lp-PLA2水平显著升高，HDL显著降低；Hs-CRP、IL-6呈正相关，Lp-PLA2与LDL呈正相关，与HDL呈负相关。结论：心绞痛血瘀证不同证型与冠心病危险因素存在内在联系，炎症因

3、子之间以及与部分危险因素之间存在相关性，Lp-PLA2可能对冠心病的发生发展有促进作用。关键词心绞痛；血瘀证；IL-6；LP-PLA2；临床研究TheCorrelationbetweenDifferentBloodStasisSyndromesandRiskFactorsofCoronaryHeartDiseaseandInflammationIndexesinAnginaPectorispatientsSpeciality:InternalMedicineofTCMTutor:JiWenyanAuth

4、or:WangShanshanAbstractObjective:ToanalysethedistributionofdifferentBloodStasisSyndromesofAnginaPectoris,toexplorethecorrelationbetweendifferentBloodStasisSyndromesofAnginapectorisandriskfactorsandinflammationindexesofCoronaryHeartDiseaseandtoinvestigate

5、thedifferencebetweenstableandunstableAnginapectoris.Method:OnehundredandfiftypatientsofbloodstasissyndromesofanginawerecategorizedintosixgroupsbasedonthefourexaminationmethodsofChinesemedicinesyndrometyping.Theywerecasesofqi-deficiencybloodstasissyndrome

6、,phlegmblockedbloodstasissyndrome,blooddeficiencybloodstasissyndrome,stagnantofqibloodstasissyndrome,toxicheatbloodstasissyndromeandcoldcoagulationbloodstasissyndrome.Theclinicaldataofthepatientswerecollectedandthelevelsofhigh-sensitivityC-reactiveprotei

7、n(Hs-CRP),interleukin-6(IL-6)andlipoprotein-associatedphospholipaseA2(Lp-PLA2)ofthepatientsweremeasured,basedonwhichtheSPSSdatabasewerebuilt.Wefirstanalyzedthebasicinformationandsyndromesandthenconductedalogisticregressionanalysisofthecorrelationbetweens

8、yndromesandriskfactorsandinflammationindex.Atlast,logisticregressionanalysisandmultiplestep-wiseregressionanalysiswereconductedonthecorrelationbetweenthemergerdiseaseandsyndromesandthecorrelationbetweensyndromesandinflamma