高敏C反应蛋白与不稳定型心绞痛中医证型相关性研究

目的探讨高敏C反应蛋白(hs-CRP)与不稳定型心绞痛(UAP)中医证型的关系以及hs-CRP与UAP临床危险度的关系。方法选择符合诊断的UAP患者101例,按冠心病中医辨证标准及血瘀证辨证标准进行分型,同时对UAP进行临床危险度分层。结果UAP患者血浆hs-CRP水平较正常对照组明显升高,并随着临床危险度的增加而升高。各中医证型组血浆hs-CRP水平均升高,其中痰热血瘀证组和痰浊血瘀证组显著高于气滞血瘀证组,阴虚血瘀证组显著高于气虚血瘀组和气滞血瘀证组,气滞血瘀证组与气虚血瘀组间无明显差异,痰热血瘀证组、痰浊血瘀证组和阴虚血瘀证组间相比无显著差异。结论UAP的发生与炎症反应有密切相关,血浆hs-CRP水平可反映冠状动脉斑块是否稳定,说明hs-CRP对UAP临床诊断有参考价值,可估计其病情程度,对预测预后有帮助。UAP中医分型与血hs-CRP存在相关性,hs-CRP作为UAP中医辨证及临床危险度分层判定指标有临床价值。

Study of the Relationship between Hs-CRP and TCM-SD of UAP

Objective:To explore the relationship between high-sensitivity C-reactive protein(hs-CRP)and TCM Syndrome Differentiation-type(TCM-SD)of Unstable Angina Pectoris(UAP),the relationship between hs-CRP and UAP clinical risk level.Methods:101 patients with UAP were differentiated by adopting the standard of TCM Syndrome Differentiation for Coronary Heart Disease(CHD)revised in 1991 and the standard of Blood Stasis Syndrome revised in 1993,ranked according to clinical risk level.Results:Plasma hs-CRP level of patients with UAP was abnormally high,it add with the development of clinical risk levels.hs-CRP level in all TCM-SDT of UAP groups was abnormally high.The hs-CRP level of Phlegm Turbid-Blood stasis Syndrome group and Phlegm heat-Blood stasis Syndrome group was significantly higher than Qi stagnation-Blood stasis Syndrome group,and Yin Deficiency-Blood stasis Syndrome group was also significantly higher than Qi stagnation-Blood stasis Syndrome group and Qi Deficiency-Blood stasis Syndrome group.There was no obvious difference between Qi stagnation-Blood stasis Syndrome group and Qi Deficiency-Blood stasis Syndrome group.There was also no obvious difference between Phlegm Turbid-Blood stasis Syndrome group,Phlegm heat-Blood stasis Syndrome group and Yin Deficiency-Blood stasis Syndrome group.Conclusion:There was close relationship between UAP and inflammation reaction.The hs-CRP level could show the instability of coronary artery lesion.This shows that hs-CRP has reference value in clinical diagnosis of UAP,estimate the severity of patient's condition,and has value in predicting prognosi.Because TCM-SDT in UAP had relation to plasma level of hs-CRP,it was valuable in clinical practise that hs-CRP was regarded as objective marker of TCM-SD and clinical risk level.