冠心病血瘀证与血液检验相关指标分析
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摘要
目的探讨冠心病血瘀证与血液相关检验指标的关系。方法选择175例冠心病患者,其中血瘀证组112例,非血瘀证组63例。研究对象均在住院次日清晨平躺测量血压,空腹状态下抽取静脉血液留置标本,检测血常规和血脂、血糖、肾功能等生化指标,记录患者吸烟史。比较两组患者指标的差异性。结果血瘀证组患者的血常规中红细胞分布宽度-CV值(Rdw-cv)、红细胞分布宽度-SD值(Rdw-sd)、血小板分布宽度(Pdw)、血小板平均体积(Mpv)、血小板比积(Pct)、大型血小板比率(P-lct)均明显高于非血瘀证组(P<0.01,P<0.05);血瘀证组患者载脂蛋白B(ApoB)、血脂总胆固醇(TC)均明显高于非血瘀证组(P<0.01,P<0.05);血瘀证组中患者吸烟率明显高于非血瘀证组(P<0.05)。结论冠心病血瘀证组患者Rdw-cv、Rdw-sd、Pdw、Mpv、Pct、P-lct、TC、ApoB及烟率均明显高于非血瘀证组,差异具有统计学意义,故以上指标可以作为冠心病血瘀证中医辨证分型的客观临床指标。
Objective To investigate the relationship between blood stasis syndrome and related blood test parameters in coronary heart disease. Methods A total of 175 cases of coronary heart disease were enrolled in the study, which included 112 cases in the blood stasis syndrome group and 63 cases in the non-blood stasis syndrome group. The supine blood pressure was measured for all the subjects in the morning of the next day of hospitalization; their fasting venous blood samples were taken for routine blood test and related biochemical tests including blood lipids, blood glucose, and renal function; meanwhile, the smoking history of these patients was recorded. These indices were compared between the two groups. Results Compared with the non-blood stasis syndrome group, the blood stasis syndrome group had significantly higher values in the following routine blood test results: red blood cell distribution width-CV(RDW-CV), red blood cell distribution width-SD(RDW-SD), platelet distribution width(PDW), mean platelet volume(MPV), plateletcrit(PCT), and platelet-large cell ratio(P-LCR)(P <0.05, P <0.01),significantly higher levels of apolipoprotein B(ApoB) and total cholesterol(TC)(P<0.05 or P<0.01), and a significantly higher smoking rate(P<0.05). Conclusion RDW-CV, RDW-SD, PDW, MPV, PCT, P-LCR, TC, ApoB, and smoking rate are significantly higher in the blood stasis syndrome group of patients with coronary heart disease than in the non-blood stasis syndrome group. Therefore,the above indices can be used as objective clinical indices for the differentiation of blood stasis syndrome in patients with coronary heart disease.
Objective To investigate the relationship between blood stasis syndrome and related blood test parameters in coronary heart disease. Methods A total of 175 cases of coronary heart disease were enrolled in the study, which included 112 cases in the blood stasis syndrome group and 63 cases in the non-blood stasis syndrome group. The supine blood pressure was measured for all the subjects in the morning of the next day of hospitalization; their fasting venous blood samples were taken for routine blood test and related biochemical tests including blood lipids, blood glucose, and renal function; meanwhile, the smoking history of these patients was recorded. These indices were compared between the two groups. Results Compared with the non-blood stasis syndrome group, the blood stasis syndrome group had significantly higher values in the following routine blood test results: red blood cell distribution width-CV(RDW-CV), red blood cell distribution width-SD(RDW-SD), platelet distribution width(PDW), mean platelet volume(MPV), plateletcrit(PCT), and platelet-large cell ratio(P-LCR)(P <0.05, P <0.01),significantly higher levels of apolipoprotein B(ApoB) and total cholesterol(TC)(P<0.05 or P<0.01), and a significantly higher smoking rate(P<0.05). Conclusion RDW-CV, RDW-SD, PDW, MPV, PCT, P-LCR, TC, ApoB, and smoking rate are significantly higher in the blood stasis syndrome group of patients with coronary heart disease than in the non-blood stasis syndrome group. Therefore,the above indices can be used as objective clinical indices for the differentiation of blood stasis syndrome in patients with coronary heart disease.
引文
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[14]李果,左冠超,齐鸣,等.中医血瘀证研究进展[J].亚太传统医药,2016,12(5):71-73.
[15]李杰,袁肇凯.冠心病血瘀证的病机研究[J].中西医结合心脑血管病杂志,2006,4(7):613-615.
[16]国际心脏病学会和协会及世界卫生组织临床命名标准化联合专题组.缺血性心脏病的命名及诊断标准[J].广东医学,2011,19(15):133.
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[19]孙洁静,刘德平,李华,等.红细胞分布宽度和白细胞水平与冠心病的关系[J].中华老年医学杂志,2015,34(3):244-248.
[20] FRHéCZ Z, GOMBOS T, BORGULYA G, et al. Red cel1 distributionwidth in heart failure:prediction of clinical events and rela-tionship with markers of ineffective erythropoiesis inflammation,rena1 function, and nutritional state[J]. American Heart Journal,2009, 158:659-666.
[21] AKIN F, KSE N, AYA B, et al. Relation between red cell dis-tribution width and severity of coronary artery disease in pa-tients with acute myocardial infarction[J]. Angiology, 2013, 64(8):592-596.
[22]杨月花,张堪宝,郑冬冬.天灸治疗精神分裂症患者痰瘀互结型血脂异常的临床观察[J].世界中西医结合杂志,2017,12(5):691-693.
[23]郭志强,杨秋娴,龙明.阿托伐他汀对冠心病患者血流动力学的影响观察[J].四川医学,2013,34(12):1884-1886.
[24]刘洋,闫蕊,李祥廷.烟熏大鼠心肌组织中缺氧诱导因子-1α和血管内皮生长因子的表达[J].中国卫生标准管理,2017,8(21):132-136.
[25]廖思聪,王大新.香烟烟雾暴露诱导小鼠血管平滑肌细胞凋亡的机制[J].实用医学杂志,2018,34(14):2311-2315,2319.
[2] CHMIELA M, GAJEWSKI A, RUDNICK A K. Helicobacter pylori vs coronary heart disease-searching for connections[J]. WorldJournal of Cardiology, 2015, 7(4):187-203.
[3]胡德亮,王淦楠,季荔,等.红细胞分布宽度与冠心病患者冠状动脉粥样硬化的关系[J].临床急诊杂志,2017,18(12):923-925.
[4] NAGULA P, KARUMURRI S, OTIKUNTA A N, et al. Correla-tion of red blood cell distribution width with the severity ofcoronary artery disease-A single center study[J]. Indian Heart Jour-nal, 2017,69(6):757-761.
[5]任宪辉,杨翠珍,张瑜,等.冠心病血液检验的相关指标检测研究[J].中国地方病防治杂志,2017,32(7):759-760.
[6]葛均波,徐永健.内科学[M].北京:人民卫生出版社,2013:227-236.
[7]中华医学会心血管病学分会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.冠心病康复与二级预防中国专家共识[J].中华心血管病杂志,2013,41(4):267-275.
[8]中国中西医结合学会活血化瘀专业委员会,实用血瘀证诊断标准[J].中国中西医结合杂志,2016,36(10):1163.
[9]陈光宇,刘松山,李思洁.冠心病心绞痛患者320例证素分析和证候分型调查[J].环球中医药,2013,6(6):448-450.
[10]秦建国,翁维良,郭维琴.郭士魁学术思想探析[J].中医杂志,2015,56(15):1273-1275.
[11]高辉远.蒲辅周医案选[J].新医药学杂志,1972(1):36-40.
[12]葛保立,苗风芝.赵锡武辨治冠心病经验撷萃[J].国医论坛,1997,12(1):23-24.
[13]李灿东,吴承玉.中医诊断学[M].北京:中国中医药出版社,2012:164-165.
[14]李果,左冠超,齐鸣,等.中医血瘀证研究进展[J].亚太传统医药,2016,12(5):71-73.
[15]李杰,袁肇凯.冠心病血瘀证的病机研究[J].中西医结合心脑血管病杂志,2006,4(7):613-615.
[16]国际心脏病学会和协会及世界卫生组织临床命名标准化联合专题组.缺血性心脏病的命名及诊断标准[J].广东医学,2011,19(15):133.
[17]苏春康.脑梗死患者血小板三项参数的变化及临床意义探讨[J].西南军医,2008,10(2):69-70.
[18]乔以凤,杨艳,周保成,等.冠心病患者血常规及血脂综合指标的临床意义[J].实用临床医药杂志,2017,21(21):203-204.
[19]孙洁静,刘德平,李华,等.红细胞分布宽度和白细胞水平与冠心病的关系[J].中华老年医学杂志,2015,34(3):244-248.
[20] FRHéCZ Z, GOMBOS T, BORGULYA G, et al. Red cel1 distributionwidth in heart failure:prediction of clinical events and rela-tionship with markers of ineffective erythropoiesis inflammation,rena1 function, and nutritional state[J]. American Heart Journal,2009, 158:659-666.
[21] AKIN F, KSE N, AYA B, et al. Relation between red cell dis-tribution width and severity of coronary artery disease in pa-tients with acute myocardial infarction[J]. Angiology, 2013, 64(8):592-596.
[22]杨月花,张堪宝,郑冬冬.天灸治疗精神分裂症患者痰瘀互结型血脂异常的临床观察[J].世界中西医结合杂志,2017,12(5):691-693.
[23]郭志强,杨秋娴,龙明.阿托伐他汀对冠心病患者血流动力学的影响观察[J].四川医学,2013,34(12):1884-1886.
[24]刘洋,闫蕊,李祥廷.烟熏大鼠心肌组织中缺氧诱导因子-1α和血管内皮生长因子的表达[J].中国卫生标准管理,2017,8(21):132-136.
[25]廖思聪,王大新.香烟烟雾暴露诱导小鼠血管平滑肌细胞凋亡的机制[J].实用医学杂志,2018,34(14):2311-2315,2319.