老年人心外膜脂肪组织厚度及冠脉病变程度与中医证型的相关性研究
摘要
目的:探讨老年人心外膜脂肪组织(EAT)厚度及冠脉病变程度与中医证型之间的相关性,为临床更有针对性治疗冠心病提供实验依据,为中医认识和防治冠心病提供参考。方法:纳入我院疑似冠心病老年患者253例,按中医辨证分型分为热毒血瘀组和非热毒血瘀组,分别检测TC、TG、TNF-a、CRP、HDL-C和LDL-C浓度,测量EAT厚度,进行冠脉造影、SYNTAX积分,比较两组之间的差异。结果:253例患者中辨证为热毒血瘀者105例,非热毒血瘀者148例。两组间比较,热毒血瘀组TC、TG、TNF-a、CRP、HDL-C和LDL-C浓度均高于非热毒血瘀组(P<0.05),EAT厚度、SYNTAX积分均大于非热毒血瘀组(P<0.05),冠脉阳性率高于非热毒血瘀组(χ2=16.085,P<0.05)。结论:冠心病热毒血瘀证和非热毒血瘀证两种证型在影响炎症因子、脂类代谢、EAT、冠脉病变方面存在明显差异,热毒血瘀证患者冠状动脉粥样硬化的可能性更大。
引文
[1]彭锐,吴伟,葛昕.从炎症因子角度谈冠心病热毒病机[J].世界中西医结合杂志,2010,8(5):732-735.
[2]Iwasaki K,Matsumoto T,Aono H.Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease[J].Clin Cardiol,2013(34):166-171.
[3]Rosito GA,Massaro JM,Hoffmann U.Pericardial fat,visceral abdominal fat,cardiovascular disease risk factors,and vascular calcification in a community-based sample-the Framingham Heart Study[J].Circulation,2014(117):605-613.
[4]Wang CP,Hsu HL,Hung WC.Increased epicardial adipose tissue(EAT)volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis[J].ClinEndocrinol,2009(7):876-882.
[5]陆再英,钟南山.内科学[M].第八版.北京:人民卫生出版社,2013:267-300.
[6]沈绍功.中医心病诊断疗效标准与用药规范[M].北京:北京出版社,2001:17-18.
[7]王丽媛,韩雅君.SYNTAX及SYNTAXⅡ评分的研究进展[J].内蒙古医学杂志,2015,47(3):312-314.
[8]吴伟,彭锐.冠心病热毒病机的探讨[J].新中医,2007,39(6):3-4.
[9]吴辉,洪永敦,吴伟,等.冠心病痰热证候与炎症因子相关性探讨[J].辽宁中医杂志,2004,31(7):542-543.
[10]洪永敦,黄衍寿,吴辉,等.冠心病中医证候与炎症因子关系的临床研究[J].广州中医药大学学报,2005,22(2):81-86.
[11]高欣莉.浅谈冠心病的中医症候要素及证型形式[J].求医问药,2013,11(10):172-173.
[12]Risbano MG,Meadows CA,Coldren CD,et al.Altered immune phenotype in peripheral blood cells of patients with scleroderma-associated pulmonary hypertension[J].Clin Transl Sci,2013,3(5):210-218.
[13]Austin ED,Rock MT,Mosse CA,et al.T lymphocyte subset abnormalities in the blood and lung in pulmonary arterial hypertension[J].Respir Med,2015,104(3):454-462.
[14]林侃,郑关毅,熊尚全,等.冠状动脉病变程度及中医证型对冠心病患者左室重构的影响[J].中医杂志,2018,59(5):851-856.
[15]薛峥,叶玺,谢年谨.急性冠脉综合征冠脉病变与中医证型的相关性分析[J].南京中医药大学学报,2017,33(5):239-241.
[2]Iwasaki K,Matsumoto T,Aono H.Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease[J].Clin Cardiol,2013(34):166-171.
[3]Rosito GA,Massaro JM,Hoffmann U.Pericardial fat,visceral abdominal fat,cardiovascular disease risk factors,and vascular calcification in a community-based sample-the Framingham Heart Study[J].Circulation,2014(117):605-613.
[4]Wang CP,Hsu HL,Hung WC.Increased epicardial adipose tissue(EAT)volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis[J].ClinEndocrinol,2009(7):876-882.
[5]陆再英,钟南山.内科学[M].第八版.北京:人民卫生出版社,2013:267-300.
[6]沈绍功.中医心病诊断疗效标准与用药规范[M].北京:北京出版社,2001:17-18.
[7]王丽媛,韩雅君.SYNTAX及SYNTAXⅡ评分的研究进展[J].内蒙古医学杂志,2015,47(3):312-314.
[8]吴伟,彭锐.冠心病热毒病机的探讨[J].新中医,2007,39(6):3-4.
[9]吴辉,洪永敦,吴伟,等.冠心病痰热证候与炎症因子相关性探讨[J].辽宁中医杂志,2004,31(7):542-543.
[10]洪永敦,黄衍寿,吴辉,等.冠心病中医证候与炎症因子关系的临床研究[J].广州中医药大学学报,2005,22(2):81-86.
[11]高欣莉.浅谈冠心病的中医症候要素及证型形式[J].求医问药,2013,11(10):172-173.
[12]Risbano MG,Meadows CA,Coldren CD,et al.Altered immune phenotype in peripheral blood cells of patients with scleroderma-associated pulmonary hypertension[J].Clin Transl Sci,2013,3(5):210-218.
[13]Austin ED,Rock MT,Mosse CA,et al.T lymphocyte subset abnormalities in the blood and lung in pulmonary arterial hypertension[J].Respir Med,2015,104(3):454-462.
[14]林侃,郑关毅,熊尚全,等.冠状动脉病变程度及中医证型对冠心病患者左室重构的影响[J].中医杂志,2018,59(5):851-856.
[15]薛峥,叶玺,谢年谨.急性冠脉综合征冠脉病变与中医证型的相关性分析[J].南京中医药大学学报,2017,33(5):239-241.