刘雪娜,熊尚全,蔡少杭

• 1:福建省漳州市中医院
• 2:福建省人民医院

摘要(Abstract)：

目的探讨不稳定型心绞痛(UAP)中医证型及临床危险度分层与颈动脉内膜-中层厚度(IMT)及高敏C反应蛋白(hs-CRP)的关系。方法将患者按Braunwald UAP分类法进行临床危险度分层,并按冠心病中医辨证标准进行辨证分型;入选的107例UAP患者及30例对照组均检查IMT及hs-CRP。结果 UAP患者IMT及hs-CRP水平明显高于对照组,随着临床危险度的增高而有明显差别;UAP患者血清hs-CRP水平与颈动脉IMT呈正相关;UAP患者血瘀证、痰浊证、痰瘀互结证到气虚血瘀证,IMT及hs-CRP均呈现不断增高的趋势。结论 hs-CRP及IMT与UAP的诊断及危险分层存在相关性,对于UAP的预测及危险度判断具有重要意义;UAP的中医辨证分型与IMT及hs-CRP存在相关性,IMT及hs-CRP作为中医辨证分型的客观化、量化指标有一定的临床价值。

关键词(KeyWords)： 不稳定型心绞痛;颈动脉内膜-中层厚度;高敏C反应蛋白;中医辨证分型

Abstract:

Keywords:

基金项目(Foundation): 福建省漳州市科学技术协会2009年重点课题研究项目(NO10)

作者(Author): 刘雪娜,熊尚全,蔡少杭

参考文献(References)：

• [1]中国中西医结合学会心血管学会.冠心病中医辨证标准[J].中西医结合杂志,1991,11(5):257.
• [2]Ross R.Atherosclerosis-an inflammatory disease[J].N Engl JMed,1999,340(11):115-126.
• [3]Libby P,Ridker P M,Maseri A.Inflammation and atheroscle-rosis[J].Circulation,2002,105(4):1135-1143.
• [4]Wilson A M,Ryan M C,Boyle A J.The novel role of C-reactiveprotein in cardiovascular disease:risk marker or pathologen[J].Int J Cardiol,2006,106(3):291-297.
• [5]Leary D H,Polak J F.Intima一media thickness:a tool foratherosclerosis imaging and event prediction[J].Am J Cardi-ol,2002,90(1):18.
• [6]Graven T E,Ryu J E,Esymeland M A,et al.Evaluation of theextracranial carotid artery[J].Circulation,1990,82(2):1230-1242.
• [7]Geroulakos G,Gorman D J,Kalodiki E,et al.The carotid inti-ma-media thickness as a marker of the presence of severesymptomatic coronary artery disease[J].Eur Heart J,1994,15(6):781-785.
• [8]Rohani M,Jogestrand T,Ekberg M,et al.Interrelation be-tween the extent of atherosclerosis in the thoracic aorta,carotid intima-media thickness and the extent of coronaryartery disease[J].Atherosclerosis,2005,179(2):311-316.
• [9]Kablak-Ziembicka A,Tracz W,Przewlocki T,et al.Associa-tion of increased carotid intima-media thickness with the ex-tent of coronary artery disease[J].Heart,2004,90(11):1286-1290.
• [10]程洁,吕宝经,郑宏超,等.颈动脉粥样硬化与冠状脉狭窄程度的关系[J].中国动脉硬化杂志,2004,12(1):66-68.
• [11]Held P,Hjemdahl S V,Eriksson.Prognostic implications of in-timia-media thickness and plaques in the carotld and femoralavteries in patients with stable angina pectoris[J].Eur HeartJ,2001,22(5):62-72.
• [12]秦昌遇.症因脉治[M].北京:中医古籍出版社,2000:235.
• [13]黄惠勇.冠心病病机的阶段论[J].中国医药学报,1996,11(2):21-22.