血脂异常不同证候间载脂蛋白B/载脂蛋白A1、纤维蛋白原特点及其与证候程度的相关性研究

目的探讨血脂异常不同证候间载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)、纤维蛋白原特点及其与证候程度的关系。方法选择2019年9月1日—2020年1月15日在辽宁中医药大学附属医院住院且符合入组标准的血脂异常患者61例,收集患者相关信息;根据中医证候辨识标准对患者进行证候的辨识,并采用中医证候量表量化证候的严重程度,统计脾肾阳虚证和痰浊阻遏证例数,比较2种证型间人口学资料、ApoB/ApoA1、血浆纤维蛋白原水平,分析2种证型患者中医证候评分与ApoB/ApoA1、血浆纤维蛋白原水平的相关性。结果61例患者中,脾肾阳虚证25例,痰浊阻遏证36例。痰浊阻遏证和脾肾阳虚证患者年龄、呼吸、心率、血压比较差异均无统计学意义(P均>0.05)。痰浊阻遏证患者ApoB/ApoA1明显高于脾肾阳虚证患者(P<0.05),血浆纤维蛋白原水平与脾肾阳虚证患者比较差异无统计学意义(P>0.05)。脾肾阳虚证血脂异常患者中医证候积分与ApoB/ApoA1、纤维蛋白原水平呈正相关性(P均<0.05)。结论血脂异常痰浊阻遏证患者的ApoB/ApoA1更高,可以一定程度上反映证候的特点;ApoB/ApoA1、纤维蛋白原水平能一定程度上反映脾肾阳虚证血脂异常患者的证候严重程度;上述特点与该疾病下的中医病因病机分析相一致,丰富了中医辨证的内涵。

Study on the characteristics of apolipoproteinB/apolipoproteinA1 and fibrinogen in different syndromes of dyslipidemia and their correlation with the degree of syndromes

Objective It is to explore the characteristics of apolipoprotein B/apolipoprotein A1(ApoB/ApoAI)and fibrinogen in different syndromes of dyslipidemia and their relationship with the degree of syndrome.Methods 61 patients with dyslipidemia hospitalized in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 1,2019 to January 15,2020 and meet the enrollment criteria were selected,and their relevant information was collected.The syndromes of the patients were judged by the traditional Chinese medicine(TCM)syndrome identification criteria,and the severity of the syndrome was quantified by the TCM Syndrome Scale,the numbers of cases of spleen-kidney Yang deficiency syndrome and phlegm-turbid obstruction syndrome were counted,the demographic data,ApoB/ApoA1,and plasma fibrinogen levels between the two syndromes were compared,the correlation of the TCM syndrome scores of patients of the two syndromes with ApoB/ApoA1,plasma fibrinogen level were analyzed.Results Among 61 patients,there were 25 cases of spleen and kidney Yang deficiency and 36 cases of phlegm turbidity obstruction.There was no significant difference in age,respiration,heart rate,and blood pressure between patients with phlegm-turbid obstruction syndrome and spleen-kidney Yang deficiency syndrome(all P>0.05).ApoB/ApoA1 in patients with phlegm turbidity obstruction syndrome was significantly higher than that in patients with spleen and kidney Yang deficiency(P<0.05),and there was no significant difference in plasma fibrinogen levels compared with patients with spleen and kidney Yang deficiency(P>0.05).The TCM syndrome scores of dyslipidemia patients with spleen-kidney Yang deficiency were positively correlated with the levels of ApoB/ApoA1 and fibrinogen(all P<0.05).Conclusion ApoB/ApoA1 is higher in dyslipidemia patients with phlegm turbidity obstruction syndrome,which may reflect the difference and characteristics of the syndromes.ApoB/ApoA1 value and fibrinogen concentration can to some extent reflect the severity of dyslipidemia of spleen and kidney Yang deficiency.The above two characteristics are consistent with the etiology and pathogenesis analysis of TCM,which enriches the connotation of TCM syndrome differentiation.