冠心病患者胰岛素抵抗与中医辨证分型及纤溶系统活性的相关性研究

作者	单位
张继东	山东大学齐鲁医院中医科济南 250012
乔云	山东大学齐鲁医院中医科济南 250012
武传龙	山东大学齐鲁医院中医科济南 250012
孙巍巍	山东大学齐鲁医院中医科济南 250012
胡连海	山东大学齐鲁医院中医科济南 250012

摘要点击次数: 1402

全文下载次数: 1697

中文摘要:

目的观察冠心病(CAD)患者胰岛素抵抗(IR)与中医辨证分型及纤溶系统活性的关系。方法将112例冠心病患者辨证分为心血瘀阻、痰阻心脉、气虚血瘀、气阴两虚4型,测定4型患者的空腹血糖(FBG)、空腹血胰岛素(FIns),计算胰岛素敏感指数(ISI),并与30名健康对照组的相应指标进行比较;选择90例患者测定组织型纤溶酶原激活剂(t-PA)活性和纤溶酶原激活剂抑制剂-1(PAI-1)含量,对FIns水平和ISI与t-PA活性、PAI-1含量进行直线相关分析。结果 CAD组FBG、FIns水平较健康对照组升高,差异有显著性(P<0.01),ISI较健康对照组降低(P<0.01);中医4证型ISI均低于健康对照组(P<0.01),IR在4证型均存在,其程度表现为心血瘀阻型和痰阻心脉型较气虚血瘀型和气阴两虚型为重;90例CAD患者t-PA活性、PAI-1含量与IR有相关性(P<0.01)。结论 CAD常伴有IR,中医各证型IR程度不同;CAD患者IR与纤溶系统活性异常有关。

英文摘要:

To study the correlation of insulin resistance (IR) with TCM syndrome type and activity of fib-rinolytic system in patients with coronary arterial disease (CAD). Methods One hundred and twelve CAD patients were classified according to TCM Syndrome into 4 types, the Xin-blood stasis (XBS) type, the phlegm blocking Xin-channel (PBXC) type, the Qi-insufficiency with blood stasis (QIBS) type and the both Qi-Yin deficiency (QYD) type. Patients’ fasting blood glucose (FBG), fasting blood insulin (FIns) were measured, the insulin sensitive index (ISI) calculated. Data were compared between various types, also with those obtained from 30 healthy persons in the control group respectively. Moreover, activity of tissue plasminogen activator (t-PA) and content of plasminogen activator inhibitor-1 (PAI-1) were determined in 90 patients selected from the 112 to conduct linear correlation analysis of IR with t-PA activity and PAI-1 content. Results FBG and FIns levels in the CAD patients were higher than those in the healthy control significantly (P<0.01); ISI in the 4 syndrome type of CAD patients were all lower than that in the control ( P < 0.01) . IR existed in all the 4 types, but the level in the XBS type and the PBXC type was more severe than in the other two types. Correlation analysis showed that IR was correlated with t-PA activity and PAI-1 content (P<0.01). Conclusion IR often exists in CAD patients, the severity of IR varies in patients of different TCM syndrome types, and IR is correlated with the abnormality of fibrinolytic system activity.

关闭