冠心病急性冠脉综合征中医辨证分型与ghrelin的相关性研究

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1、提要目的：通过观察冠心病急性冠脉综合征患者外周血浆中Ghrelin、甲状腺激素水平，探讨二者与冠心病及中医证型之间的相关性，为冠心病的治疗提供新的方法。方法：临床确诊的冠心病急性冠脉综合征组患者60例。患者入院时收集一般资料、症状、体征、舌象、脉象等临床资料，进行辨证分型，其中心血瘀阻证30例，气虚血瘀证30例。健康正常对照组30例。采用酶联免疫吸附法(ELISA)法检测血清Ghrelin水平，采用化学发光法测定血清甲状腺激素水平。结果：1.与健康对照组相比，冠心病组高密度脂蛋白（HDL-C）、FT3、FT4、ghrelin水平显著降低（p<0.05)；2.冠心病组患者外周血浆

2、ghrelin水平与年龄、FT3呈显著负相关，随着年龄的增加,外周血浆gherlin水平降低。3.冠心病组外周ghrelin水平心血瘀阻、气虚血瘀组显著小于健康对照组（p>0.05)，辨证分型之间无统计学差异。TSH、LDL-C水平高于健康对照组，HDL-C、FT4、FT3水平低于对照组，各组之间无统计学意义（p>0.05)。结论：1.冠心病组患者外周血浆ghrelin、甲状腺激素水平（FT3、FT4）均显著低于健康对照组；2.外周血浆ghrelin与甲状腺激素在冠心病患者中存在显著相关性。3.各中医辨证分型组血浆ghrelin、甲状腺激素水平无显著性差异。关键词冠心病；急性冠

3、脉综合征；中医辨证分型；甲状腺激素；人生长激素释放肽（ghrelin）TheCorrelationStudyofTraditionalChineseMedicineSyndromeDifferentiationofCoronaryHeartDiseasewithAcuteCoronarySyndromeandGhrelinSpeciality：Cardiovasculardisease，InternalMedicineofTCMAuthor：SunguizhiTutor：ProfessorWuYinanAbstractObjective:Toinvestigatechanges

4、ofcirculatinggherlinandthyroidhormonelevelsandtheirsignificantinCADwithacutecoronarysyndromepatients,ExplorethecorrelationbetweentheTCMsyndrometypeandcoronaryheartdisease，toprovideanewmethodinthetreatmentofcoronaryheartdisease.Methods:60CHDwithacutecoronarysyndromepatientsaredefinedinclinic.

5、Collectingthepatients’generalinformation,includingsymptom,sign,tongue,pulseandotherclinicalinformations,thenwedivideallthepatientsintotwoclinicaltypesofTCMsyndrome:30casesoftheheartBloodstasissyndromegroup,30casesofdebilitybloodstasissyndromemeridiansyndromegroup,ToadoptELISAmethodtodetectth

6、elevelofserumGhrelin,usingchemicalluminescencemethodtodeterminetheserumthyroidhormonelevels.Results:1.TheCHDgroupofhigh-densitylipoprotein(HDL-C),FT3,FT4gherlinlevelsaremorebelowthannormalcontrolgroup,havingsignificantdifferencebetweentwogroups(P<0.05)；2.Coronaryheartdiseasepatientsperiphera

7、lbloodplasmalevelsofghrelinwithage,FT3isasignificantnegativecorrelation,alongwiththeincreaseofage,peripheralgherlinreducedlevel.3.TheCHDgroupghrelinlevelswithbloodstasisduetofriction,andbloodstasisaremuchsmallerthangrouphealthincontrolgroup(p<0.05)