Correlations between TCM syndromes of coronary heart disease and body mass index, levels of blood lipid as well as manifestations of coronary CT angiography
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摘要:目的 探讨冠心病中医证型与体质量指数（BMI）、血脂水平及冠状动脉CT血管造影（CTA）表现的相关性。方法 回顾性分析153例冠心病患者的中医证型、BMI、血脂水平及冠状动脉CTA表现，分析不同证型与BMI、血脂水平及冠状动脉狭窄程度、病变支数的关系。结果 痰阻心脉证患者BMI值与其他证型比较，差异有统计学意义（P < 0.01）；心血瘀阻证与气滞血瘀、心肾阴虚证患者BMI值比较，差异有统计学意义（P < 0.01）。痰阻心脉证与心血瘀阻证TG及LDL-C水平高于其他证型，差异有统计学意义（P < 0.01）。心血瘀阻证、气虚血瘀证型患者以重度狭窄表现为主，痰阻心脉与心血瘀阻证患者以多支病变为主，多数此类患者病情较重，心肾阴虚证患者以单支病变为主，此类患者病情较轻。结论 冠心病中医证型与冠状动脉CTA检查显示的冠状动脉病变支数、狭窄程度及BMI、血脂水平密切相关，可将冠状动脉CTA检查结果、BMI、血脂水平作为胸痹辨证的客观指标。
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关键词:
- 冠心病 /
- 胸痹 /
- 体质量指数 /
- 血脂 /
- 冠状动脉CT血管造影
Abstract:Objective To investigate the correlations between TCM syndromes of coronary heart disease and body mass index(BMI), blood lipid levels as well as coronary CT angiography(CTA) manifestations in cardiac patients.Methods Retrospective analysis was performed in TCM syndromes of coronary heart disease, BMI, blood lipid levels and manifestations of coronary CTA in 153 patients. The relationships between different syndromes and BMI, blood lipid level, degree of coronary artery stenosis and the number of diseased coronary branches were analyzed.Results Compared with patients with other syndromes, there were significant differences in BMI values of patients with phlegm obstruction of heart arteries (P < 0.01). There were also significant differences in BMI values among patients with stagnation of the heart blood syndrome and qi stagnation and blood stasis syndrome, syndrome of yin deficiency in heart and kidney(P < 0.01). The levels of TG and LDL-C in phlegm-obstructing heart vein syndrome and heart-blood stasis syndrome were higher than those in other syndromes(P < 0.01). Patients with heart-blood stasis syndrome and qi deficiency and blood stasis syndrome were mainly characterized by severe stenosis, and those with phlegm-obstructing heart veins and heart-blood stasis syndrome were mainly characterized by multi-vessel disease, and most of them had severe disease. Patients with heart-kidney yin deficiency syndrome were mainly characterized by single-vessel disease, and such patients had mild disease.Conclusion The TCM syndromes of coronary heart disease are closely related to the number of diseased coronary branches and the severity of coronary stenosis manifested by coronary CTA, BMI and blood lipid levels. The results of coronary CTA examination, BMI and blood lipid levels can be considered as objective indexes for syndrome differentiation in patients with obstruction of qi in the chest. -
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表 1 CHD不同证型性别分布情况
性别 心血瘀阻 痰阻心脉 气滞血瘀 气虚血瘀 心肾阴虚 男 40 12 12 5 6 女 15 23 11 17 12 占总人数比率/% 35.95 22.88 15.03 14.38 11.76 
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表 2 不同证型BMI分布情况比较例
BMI 心血瘀阻 痰阻心脉 气滞血瘀 气虚血瘀 心肾阴虚 正常人群 < 18.5 kg/m2 5 0 2 1 5 18.5~ < 24 kg/m2 25 2 16 16 12 超重人群 24~ < 28 kg/m2 18 25 3 4 1 ≥28 kg/m2 7 8 2 1 0
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表 3 不同证型TG、LDL-C比较(x±s)
mmol/L 指标 心血瘀阻 痰阻心脉 气滞血瘀 气虚血瘀 心肾阴虚 TG 3.30±0.35 2.95±0.23 2.39±0.14 1.73±0.17 1.59±0.31 LDL-C 4.46±0.45 4.48±0.57 3.29±0.47 3.02±0.32 2.99±0.28 TG: 甘油三酯; LDL-C: 低密度脂蛋白胆固醇。
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表 5 CHD不同证型冠状动脉病变支数分布情况例
证型 心血瘀阻 痰阻心脉 气滞血瘀 气虚血瘀 心肾阴虚 单支病变 2 7 13 12 17 双支病变 31 20 8 9 1 三支病变 22 8 2 1 0
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