中国中西医结合杂志2024，Vol.44Issue(2)：149-155,7.DOI:10.7661/j.cjim.20230923.249
冠状动脉粥样硬化性心脏病中医证型与冠状动脉造影及血液生化指标相关性研究
Correlation of Coronary Angiography and Blood Biochemical Indexes Among Different Chinese Medicine Syndromes of Coronary Atherosclerotic Heart Disease
摘要
Abstract
Objective To observe the relationship between different Chinese medicine(CM)syndromes of coronary atherosclerotic heart disease(CAHD)with coronary angiography(CAG),blood biochemical indexes,and major adverse cardiovascular events(MACE).Methods A total of 686 CAHD patients who visited Peking University International Hospital and Peking University People's Hospital from May,2015 to Oct,2018 were enrolled.The patients were assigned to qi-stagnation and blood-stasis type(221 cases),phlegm-turbidity blocking collateral type(189 cases),qi-deficiency and blood-stasis type(178 cases),qi-yin deficiency type(50 cases),and yin-cold stagnation type(48 cases)according to CM syndromes.The levels of blood biochemical indexes and the results of CAG of different CM syndromes were compared.A 3 years follow-up was conducted.Results Compared with qi-stagnation and blood-stasis type,apolipoproteins B(ApoB),apolipoproteins A-1(ApoA1),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),lipoprotein(a)[Lp(a)],and Gensini score decreased in phlegm-turbidity blocking collateral type(P＜0.05);ApoB,ApoA1,TC,LDL-C,Lp(a),small and dense LDL-C(sdLDL-C),and Gensini score decreased(P＜0.05),proportion of 1 vessel disease increased in qi-deficiency and blood-stasis type(P＜0.05);ApoA1,fasting plasma glucose(FPG),and glycated hemoglobin A1c(HbA1c)increased(P＜0.05),ApoB,TC,LDL-C,Lp(a),sdLDL-C,proportion of 3 vessels disease,Gensini score,and overall incidence of MACE decreased in qi-yin deficiency type(P＜0.05);ApoA1,high-density lipoprotein cholesterol(HDL-C),and proportion of 1 vessel disease increased(P＜0.05),ApoB,TC,LDL-C,Lp(a),sdLDL-C,proportion of 3 vessels disease,Gensini score,and overall incidence of MACE decreased in yin-cold stagnation type(P＜0.05).Compared with phlegm-turbidity blocking collateral type,ApoA1 and proportion of 1 vessel disease increased(P＜0.05),ApoB,TC,and Gensini scored decreased in qi-deficiency and blood-stasis type(P＜0.05);ApoA1,HbA1c,and proportion of 1 vessel disease increased(P＜0.05),ApoB,TC,LDL-C,Lp(a),sdLDL-C,proportion of 3 vessels disease,and Gensini score decreased in qi-yin deficiency type(P＜0.05);ApoA1,HDL-C,and proportion of 1 vessel disease increased(P＜0.05),ApoB,TC,LDL-C,sdLDL-C,proportion of 3 vessels disease,Gensini score,and overall incidence of MACE decreased yin-cold stagnation type(P＜0.05).Compared with qi-deficiency and blood-stasis type,ApoA1 increased(P＜0.05),LDL-C,Lp(a),and Gensini score decreased in qi-yin deficiency type(P＜0.05);ApoA1 increased in qi-yin deficiency type(P＜0.05),TC and Gensini score decreased in yin-cold stagnation type(P＜0.05).Compared with qi-yin deficiency type,TC,FPG,HbA1c,and Gensini score decreased in yin-cold stagnation type(P＜0.05).There were statistic differences in survival curves among different CM syndrome types(P=0.017).The survival curve of qi-deficiency and blood-stasis type decreased first,and MACE occurred first.With the passage of time,the survival curve of qi-stagnation and blood-stasis type and phlegm-turbidity blocking collateral type decreased obviously,and the proportion of MACE increased obviously(P＜0.05).Conclusion There is a correlation between CAG,biochemical indicators,MACE and CM syndromes of CAHD,which has guiding significance for syndrome differentiation and prognosis of CAHD.关键词
冠状动脉粥样硬化性心脏病/中医证候/冠状动脉造影/生化指标/主要不良心血管事件Key words
coronary atherosclerotic heart disease/Chinese medicine syndromes/coronary arteriography/blood biochemical indexes/major adverse cardiovascular events引用本文复制引用
黄娟,姚小芹,熊祎虹,杨明,苏明,张学智..冠状动脉粥样硬化性心脏病中医证型与冠状动脉造影及血液生化指标相关性研究[J].中国中西医结合杂志,2024,44(2):149-155,7.基金项目
国家自然科学基金资助项目(No.81870196) （No.81870196）
