摘要
目的：探讨慢性心力衰竭（CHF）患者中医辨证分型与血清胱抑素C（Cys-C）和同型半胱氨酸（Hcy）的相关性。方法选择浙江中医药大学附属第一医院心内科收治的115例CHF患者作为CHF组，以同期本院30例健康体检者作为健康对照组，再将CHF患者按中医辨证分型标准分为气阴两虚证30例，气虚血瘀证30例，心肾阳虚证30例和阳虚水泛证25例。检测各组血清Cys-C和Hcy水平，采用Spearman等级相关分析评价不同中医证型与血清Cys-C和Hcy的相关性。结果 CHF组Cys-C和Hcy水平显著高于健康对照组〔Cys-C（mg/L）：1.24±0.34比0.77±0.22，Hcy（μmol/L）：18.66±4.57比11.65±3.21，均P＜0.05〕。与健康对照组比较，Cys-C和Hcy水平按气阴两虚证、气虚血瘀证、心肾阳虚证和阳虚水泛证的顺序呈逐渐增高趋势〔Cys-C（mg/L）：1.02±0.27、1.09±0.31、1.32±0.22、1.59±0.25；Hcy（μmol/L）：14.94±2.20、17.66±3.04、19.79±3.48、22.96±5.31〕，且以阳虚水泛证的升高程度最明显（P＜0.05）。相关分析显示，不同中医证型与血清Cys-C和Hcy水平呈显著正相关（r1＝0.73，r2＝0.79，均P＜0.05）。结论 CHF患者血清Cys-C和Hcy水平的变化与其辨证分型规律的演变相一致，两者可作为CHF中医辨证分型的客观指标。
ObjectiveTo investigate the relationships between traditional Chinese medicine（TCM） syndrome differentiation and serum cystatin C（Cys-C） and homocysteine（Hcy） in patients with chronic heart failure（CHF）. Methods 115 cases with CHF admitted into the Department of Cardiology of the First Affiliated Hospital of Zhejiang Chinese Medical University were selected in the CHF group, and 30 cases who had taken health examination in the same period were chosen in the healthy control group. According to the TCM syndrome differentiation, the CHF cases were subdivided into four groups with different types of syndrome： 30 cases of deficiency of both Qi and Yin syndrome, 30 cases of Qi deficiency syndrome and blood stagnation syndrome, 30 cases of heart and kidney Yang deficiency syndrome and 25 casesof flooding due to Yang deficiency syndrome. The serum levels of Cys-C and Hcy in different groups were tested, and the relationships between TCM syndrome differentiation and serum Cys-C and Hcy were analyzed by using Spearman rank correlation analysis.Results The serum levels of Cys-C and Hcy in the patients with CHF were significantly higher than those in the healthy control group〔Cys-C（mg/L）：1.24±0.34 vs. 0.77±0.22, Hcy（μmol/L）：18.66±4.57 vs. 11.65±3.21,bothP〈0.05〕. Compared with the healthy control group, the serum levels of Cys-C and Hcy in the above four groups of different syndromes had a tendency of gradual elevation in the sequence as follows： deficiency of both Qi and Yin, Qi deficiency and blood stagnation, heart and kidney Yang deficiency and flooding due to Yang deficiencygroups〔Cys-C（mg/L）：1.02±0.27,1.09±0.31,1.32±0.22, 1.59±0.25; Hcy（μmol/L）： 14.94±2.20, 17.66±3.04, 19.79±3.48, 22.96±5.31〕, and the elevation in levels of flooding due to Yang deficiency group was the most prominent compared with that in other groups（P〈0.05）. The correlation analyses showed that different types of TCM syndrome in patients with CHF were positively correlated with the levels of Cys-C and Hcy（r1=0.73,r2=0.79,bothP〈0.05）.ConclusionThe changes of serum Cys-C and Hcy levels are consistent with the evolution of regular pattern of TCM syndrome differentiation in patients with CHF, and these two markers can be regarded as the objective indicators of TCM syndrome differentiation of CHF.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2014年第5期386-388,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省中医药科研基金项目（2013ZA054）
浙江省医药卫生研究计划资助项目（2013KYB186）
