急性心肌梗死阴虚病机与短期预后关系及机理探讨

Exploration on the Relationship between Pathogenesis for Yin-deficiency of Acute Myocardial Infarction and Immediate Prognosis as well as Its Mechanism

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中文关键词: 急性心肌梗死预后神经内分泌功能阴虚

英文关键词:acute myocardial infarction prognosis neuro-endocrine function Yin-deficiency

基金项目:广东省自然科学基金博士基金资助项目(No.974238)

作者	单位
李南夷	广州中医药大学附属第一医院
李岳夷	湖南省中医药学校
洪创雄	广州中医药大学附属第一医院
龙新生	深圳市中医院

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中文摘要:

目的研究急性心肌梗死阴虚病机与短期预后的关系及其神经内分泌机理。方法按照中医虚证辨证标准将急性心肌梗死患者194例分为典型阴虚组26例、不典型阴虚组61例和非阴虚组107例.分别于清晨卧位采集静脉血测定血浆肾上腺素、去甲肾上腺素、醛固酮、心钠素、皮质醇、心肌酶等,并统计住院天数、住院期间病死率,比较3组间的差异,另选30名健康人为对照组。结果阴虚组血清肌酸磷酸激酶、肌酸磷酸激酶同功酶、血浆肾上腺素、去甲肾上腺素、醛固酮水平、住院天数、病死率均显著高于非阴虚组(P<0.05或P<0.01);典型与非典型阴虚组之间比较,仅血浆醛固酮与心钠素水平前者显著高于后者(P<0.05,P<0.01);血浆皮质醇水平在阴虚各组之间差异无显著性。结论急性心肌梗死阴虚患者心肌损害重、住院时间长、病死率高,其机理可能与交感-肾上腺素系统功能亢进,醛固酮活性增强有关。

英文摘要:

To study the relationship between pathogenesis for Yin-deficiency of acute myocardial infarction (AMI) and immediate prognosis as well as its neuro-endocrine mechanism. Methods According to the TCM standard of Syndrome Differentiation of Deficiency Syndrome, 194 patients with AMI were classified into the typical Yin-deficiency group (n =26) , the non-typical Yin-deficiency group (n =61) and the non-Yin-deficiency group ( n = 107) . Their venous blood samples were collected in the morning while lying on their backs to detect plasma levels of adrenaline, noradrenaline, aldosterone, atrial natriuretic peptide (ANP), corticoid and myocardial enzymes, as well as their hospitalization days and mortality in hospitalized period were calculated and compared in the three groups, with the 30 healthy persons as control. Results Levels of serum creatine phos-phokinase, creatine phosphokinase isozyme, plasma adrenaline, noradrenaline, aldosterone, hospitalization days and mortality were higher in the Yin-deficiency groups than in the non-Yin-deficiency group (P<0.05, P< 0.01). As compared the indexes between the typical and the non-typical Yin-deficiency groups, significant difference only showed in plasma aldosterone and ANP, which was significantly higher in the former ( P < 0.05, P <0.01). Plasma corticoid level was insignificantly different between the Yin-deficiency groups. Conclusion Patients with AMI of Yin-deficiency type was severer in myocardial damage, with longer hospitalization period and higher mortality, it is probably due to the hyper-activated sympathetic-adrenaline system and strengthened activity of aldosterone in them.

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