摘要
目的:探索冠心病患者支架植入术前、术后中医证候要素与红素氧合酶1(HO-1)、Betatrophin表达水平变化的关系,旨在筛选反应中医证候要素特征的生物标志物。方法:①2016年6月-2017年5月于西南医科大学附属中医医院就诊的住院患者,纳入确诊为冠心病且行冠状动脉支架植入术的患者193例为研究对象;②记录所有病例支架植入术前基本信息(包括性别、年龄、BMI、血脂、血压等情况)、中医证候要素辨证分型、填写CRF表、建立数据库;③观察指标:血瘀证、痰浊证、气虚证及其他证各组冠状动脉支架植入术前Gensini积分;采用ELISA法检测所有冠心病病例支架植入术前1天、术后3天内HO-1、Betatrophin表达水平在不同中医证候要素中的变化;④统计软件SPSS 20.0用于相关数据的统计描述与分析。结果:①本研究共纳入193名研究对象,不同中医证候要素患者的年龄、性别构成、吸烟史、高血压病、糖尿病、心律失常在冠状动脉支架植入术前的差异均无统计学意义(P>0.05)。术前不同中医证候要素患者的BMI、血糖、LDL-C、BNP、血尿酸、血肌酐、Gensini积分的差异均无统计学意义(P>0.05)。②配对设计t检验分析结果显示:气虚证组、血瘀证组、其他证组冠状动脉支架植入术前、术后血清Betatrophin表达差异无统计学意义(P>0.05);痰浊证组冠状动脉支架植入术前及术后血清Betatrophin表达水平差异具有统计学意义(P<0.05)。③配对设计t检验分析结果显示:气虚证组、血瘀证组、其他证组冠状动脉支架植入术前、术后HO-1表达差异无统计学意义(P>0.05);痰浊证组冠状动脉支架植入术前血清HO-1为(14.02±2.88)ng/mL,术后HO-1为(12.80±2.54)ng/mL,痰浊证患者术后HO-1表达水平比术前更低,差异具有统计学意义(P<0.05)。结论:本研究发现冠心病的中医证候要素痰浊证与血清Betatrophin、HO-1密切相关。
Objective:To explore the relationship between the changes of HO-1 and Betatrophin express levels for TCM syndrome elements before and after stent implantation of who were diagnosed as coronary artery heart disease(CHD).To screen the biomarkers that reflect the characteristics of TCM syndrome elements.Methods:①Inpatients admitted to Affiliated Chinese Medicine Hospital of Southwest Medical University from June 2016 to May 2017 were included in the study,193 patients were enrolled who were diagnosed as CHD and had coronary stent implantation.②The basic information(including gender,age,BMI,blood lipids and blood pressure),elements of TCM syndromes were recorded,the CRF form was filled in and the database was established.③Observation indexes included Gensini score of blood stasis syndrome,Phlegm-turbid syndrome,Qi deficiency syndrome and other syndromes before coronary stent implantation;The changes of HO-1 and serum Betatrophin express in different TCM syndrome elements were measured by ELISA in all cases 1 day before and 3 days after coronary stent implantation.④Then statistical software SPSS20.0 was used for statistical description and analysis of related data.Results:①A total of 193 subjects were included in the study.Chi-square test and one-way ANOVA showed that there was no significant difference in age,gender,smoking history,hypertension,diabetes,and arrhythmia before coronary artery stent implantation in patients with different TCM syndrome elements(P>0.05).One-way ANOVA and rank-sum test showed that there were no significant differences in BMI,blood glucose,LDL-C,BNP,serum uric acid,serum creatinine,and Gensini scores in patients with different TCM syndromes before surgery(P>0.05).②The paired design t-test analysis showed that there was no significant difference in serum Betatrophin express before and after coronary stent implantation in the Qi deficiency group,blood stasis syndrome group,and other syndrome groups(P>0.05);The level of Betatrophin expression after stent implantation in patients with phlegm-turbid syndrome was higher than that before stent implantation,and the difference was statistically significant(P<0.05).③Paired design t-test was used to compare the differences of serum HO-1 levels before and after coronary implantation in patients with different TCM syndromes.The results showed that:there was no significant difference in the expression of HO-1 before and after stent implantation in Qi deficiency group,blood stasis group,and other syndromes(P>0.05).The postoperative HO-1 expression level in the patients with phlegm-turbid syndrome was lower than that before coronary stent implantation,and the difference was statistically significant(P<0.05).Conclusion:This study founded that the phlegm-turbid syndrome in the TCM syndrome elements of coronary heart disease was closely related to serum Betatrophin and HO-1.
作者
李长江
陈乔
杨思进
白雪
Li Changjiang;Chen Qiao;Yang Sijin;Bai Xue
出处
《中医临床研究》
2019年第36期39-42,共4页
Clinical Journal Of Chinese Medicine
