冠心病的中医辨证分型与血浆脂质、脂蛋白及载脂蛋白水平的关系

264例冠心病人经中医辨证分为气虚血瘀、气阴两虚、肝肾阴虚、瘀浊和阳虚五型。分别测定其血压、体重指数(BMI)、血脂(TG、TC)、脂蛋白(VLDLc、LDLc、HDLc)、脂蛋白亚组分(HDL2c、HDL3c)和 apo(A-Ⅰ、A-Ⅱ、B100、C-Ⅲ、E)的水平,冠脉风险指数(C Ⅰ)及 apoB/A-Ⅰ比值。结果表明:冠心病人 BMI 和血浆 TG、TC、VLDLc的水平以及 CⅠ和 apoB/A-Ⅰ比值显著高于健康对照组,HDLc、HDL2c、apoA-Ⅰ的水平明显低于对照组(P<0.01)。辨汪分型后分析发现,上述血浆脂蛋白和载脂蛋白的改变以气虚血瘀和气阴两虚型冠心病人最显著。瘀浊型冠心病人 BMI 值及 apoB 的水平最高,apoB/A-Ⅰ比值显著高于气阴两虚、肝肾阴虚和阳虚型冠心病人(P<0.01)。肝肾阴虚型患者血压明显偏高。阳虚型冠心病人血浆脂蛋白代谢改变最轻,除 HDLc、HDL2c 和 apoA-Ⅰ水平降低外,其它各项指标与健康对照组无统计学差异。

RELATION BETWEEN DIFFERENTIATION OF ZHENG OF CORONARY DISEASE AND LEVEL OF PLASMA LIPIDE,LIPOPROTEIN AND APOLIPOPROTEIN

264 cases of coronary disease are divided into four differetiation groups of zheng as follows:insufficiency of qi and blood stasis, insufficiency of both qi and yin,deficiency of liver-yin and kidney-yin, phlegm,deficiency of yang.BMI,TG,TC,VLDLc,LDLc,HDLc,HDL2c, HDL3c and APO,CI AND APO B/A-I of patients were determined and controlled to the healthy people.It is found that the levels of BMI,TG, TC,VLDLc and CI,APO B/A-I in patients arc much higher than the levels of the healthy one but levels of HDLc,APOA-I in patients are lower than the healthy one (p<0.01).The levels of VLDLc,VDLc increase obviously in the cases of insufficiency of qi and blood stasis and insufficiency of both qi and yin,patients with phlegm zheng have the highest BMI of the four groups.Otherwise,patients with defficieney of both qi and yin have high blood pressure and patients with defficiency of yang have nearly normal levels of mest indexes.