【摘要】：目的:本研究通過檢測入選研究對象血漿Lp-PLA2的水平,了解冠心病三種中醫(yī)證型(痰濁證、血瘀證和氣虛證)患者PCI術后Lp-PLA2水平的差異,探討PCI術后增高的Lp-PLA2水平在冠心病哪一中醫(yī)證型患者中居多,分析冠心病中醫(yī)證型患者冠脈病變的嚴重程度,預測不同中醫(yī)證型患者PCI術后冠狀動脈再發(fā)狹窄的可能性大小。方法:擬選取廣東省中西醫(yī)結合醫(yī)院2016年4月-2016年12月心血管內科住院的并行PCI術的冠心病病人75例作為研究組,根據中醫(yī)辨證分型標準分為三型:痰濁證、血瘀證和氣虛證。對照組為該時段內健康體檢者25例(年齡在40-90歲之間,男女均可)。符合條件的對照組人群在入院時空腹抽血、研究組分別在術后第1天及第4天空腹抽血,兩組間Lp-PLA2水平均采用免疫增強比濁法測定。比較研究組與健康對照組的Lp-PLA2的水平,并且比較冠心病不同中醫(yī)證型組患者PCI術后第1、第4天血漿Lp-PLA2的水平,對比三組西醫(yī)類型冠心病患者經皮冠狀動脈介入術后不同時段Lp-PLA2的差異。研究的結果采用SPSS 19.0進行數據分析。結果:1、冠心病PCI術研究組術后第1天、第4天Lp-PLA2水平均高于健康對照組,差異有統(tǒng)計學意義(P0.05)。2、冠心病PCI術后第1天三組不同中醫(yī)證型患者間Lp-PLA2水平不相等,經兩兩比較,Lp-PLA2水平由高到低為痰濁證血瘀證氣虛證。3、冠心病PCI術后第4天三組不同中醫(yī)證型患者間Lp-PLA2水平不相等,經兩兩比較,Lp-PLA2水平由高到低為痰濁證血瘀證氣虛證。4、冠心病PCI術后第1天三組不同西醫(yī)類型冠心病患者間Lp-PLA2水平各有差異,經統(tǒng)計學比較,Lp-PLA2水平由高到低為AMIUAPSAP。5、冠心病PCI術后第4天三組不同西醫(yī)類型冠心病患者間Lp-PLA2水平各不相同,經兩兩比較,Lp-PLA2水平按照AMIUAPSAP的順利排列。結論:Lp-PLA2作為一種強烈的血管促炎因子,可以評價冠脈病變的活動性,是冠脈病變嚴重程度的評估指標,可以作為冠心病三種不同西醫(yī)類型患者PCI術后出現(xiàn)冠脈再狹窄可能性大小的判斷指標;冠心病不同中醫(yī)辨證分型患者間PCI術后Lp-PLA2水平存在明顯的差別,可以為冠心病的中醫(yī)辨證提供客觀依據、指導冠心病的中醫(yī)藥臨證用藥,也可作為判斷冠心病哪種中醫(yī)證型患者PCI術后再發(fā)狹窄可能性更大的客觀指標。
[Abstract]:Objective: to investigate the difference of Lp-PLA2 level among three TCM syndromes of coronary heart disease (phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome) by detecting the level of plasma Lp-PLA2 in patients with coronary heart disease, to explore which TCM syndrome type of coronary heart disease has increased Lp-PLA2 level in which TCM syndrome type of coronary heart disease, and to analyze the severity of coronary artery disease in patients with traditional Chinese medicine syndrome type of coronary heart disease. To predict the possibility of recurrent coronary artery stenosis after PCI in patients with different TCM syndromes. Methods: 75 patients with coronary heart disease hospitalized in Department of Cardiovascular Medicine from April 2016 to December 2016 in Guangdong Integrated traditional Chinese and Western Medicine Hospital were selected as the study group. According to the syndrome differentiation criteria of traditional Chinese medicine, they were divided into three types: phlegm turbid syndrome, blood stasis syndrome and qi deficiency syndrome. The control group was 25 healthy subjects (between 40 years old and 90 years old, both male and female). Fasting blood was drawn from the eligible control group on admission, and fasting blood was drawn on the 1st and 4th day after operation, and the levels of Lp-PLA2 were measured by immunoturbidimetry. The levels of Lp-PLA2 in the study group and the healthy control group were compared, and the plasma Lp-PLA2 levels in the patients with different TCM syndrome types of coronary heart disease were compared on the 1st and 4th day after PCI, and the differences of Lp-PLA2 in the three groups of patients with coronary heart disease at different time points after percutaneous coronary intervention were compared. The results were analyzed by SPSS 19.0. Results: 1. The level of Lp-PLA2 in the study group was significantly higher than that in the healthy control group on the 1st and 4th day after operation (P 0.05). 2, the level of Lp-PLA2 in the three groups on the first day after PCI was not equal. Through pairwise comparison, the level of Lp-PLA2 was phlegm, turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 3, On the 4th day after PCI, the level of Lp-PLA2 was not equal among the three groups of patients with different TCM syndromes. By pairwise comparison, the level of Lp-PLA2 was from high to low for phlegm and turbid syndrome, blood stasis syndrome and qi deficiency syndrome. 4. On the first day after coronary heart disease PCI, there were differences in Lp-PLA2 level among the three groups of different western medicine types of coronary heart disease. After statistical comparison, the level of Lp-PLA2 was AMIUAPSAP.5, from high to low. On the 4th day after PCI, the levels of Lp-PLA2 in the three groups were different among different types of coronary heart disease (CAD). By pairwise comparison, the Lp-PLA2 levels were arranged smoothly according to AMIUAPSAP. Conclusion: Lp-PLA2, as a strong vascular pro-inflammatory factor, can evaluate the activity of coronary artery disease, is an index to evaluate the severity of coronary artery disease, and can be used as an index to judge the possibility of coronary restenosis in patients with three different types of coronary heart disease after PCI. There are obvious differences in Lp-PLA2 level among different TCM syndrome differentiation patients of coronary heart disease after PCI, which can provide objective basis for TCM syndrome differentiation of coronary heart disease, guide the clinical use of traditional Chinese medicine for coronary heart disease, and can also be used as an objective index to judge which TCM syndrome type of coronary heart disease patients have greater possibility of recurrent stenosis after PCI.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.4

【參考文獻】

相關期刊論文 前10條

1 羅穎;王麗麗;龍娟;衣晨;;血漿Lp-PLA2水平與冠脈支架置入術后再狹窄相關性探討[J];陜西醫(yī)學雜志;2015年06期

2 杜博;趙學忠;;冠心病患者支架內再狹窄的危險因素[J];中國老年學雜志;2015年10期

3 謝睿彬;張小新;蘇華;廖佩娟;譚泰康;;不同類型冠心病介入治療的研究進展[J];中國醫(yī)學創(chuàng)新;2013年15期

4 王居新;張亞艷;;益氣活血湯治療冠脈介入術后再狹窄36例[J];云南中醫(yī)中藥雜志;2013年01期

5 何勁松;劉婧;白法文;劉鈞超;;冠狀動脈粥樣硬化性心臟病患者PCI術后胸痛的研究進展[J];醫(yī)學綜述;2011年16期

6 劉敏;張培影;;不穩(wěn)定性心絞痛中醫(yī)證型與HCY、hs-CRP的關系[J];浙江中西醫(yī)結合雜志;2009年07期

7 扶桂升;;復方丹參滴丸預防冠心病患者支架術后再狹窄的臨床觀察[J];中國醫(yī)藥導報;2009年09期

8 王師菡;王階;何慶勇;李霽;;冠心病介入術后中醫(yī)證候要素分布規(guī)律及相關因素分析[J];世界科學技術-中醫(yī)藥現(xiàn)代化;2008年06期

9 邱雪峰;董念國;;冠心病外科治療的新進展[J];心肺血管病雜志;2008年05期

10 何慶勇;王階;張允嶺;吳榮;;冠心病介入術后再狹窄危險因素及中醫(yī)證候要素分析[J];北京中醫(yī)藥大學學報;2008年08期

相關博士學位論文 前1條

1 郭方明;冠脈介入干預后血流及炎癥因子的臨床研究[D];天津醫(yī)科大學;2010年

相關碩士學位論文 前2條

1 萬冬華;血漿脂蛋白相關磷脂酶A2在冠心病中醫(yī)證型中的臨床研究[D];廣州中醫(yī)藥大學;2016年

2 羅瓊;急性冠脈綜合征患者血漿Lp-PLA2活性變化及PCI術對其的影響[D];南華大學;2012年

，

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