Serum Level Of Platelet Coat Glycoprotein And Lysophosphatidic Acid In Coronary Heart Disease Patients And Its Relationship To Traditional Chinese Medicine Syndrome Differentiation-Type

Aim: By comparing the serum level of LPA, CD62P, PAC1 in coronary heart disease patients (CHD) with Traditional Chinese Medicine Syndrome Differentiation-Type(TCM-SDT) and score of syndrome of blood stasis, to investigate the mechanisms of CHD and its relationship to Zheng type of TCM as well as syndrome of blood stasis. Our result will provide theoretical and clinical references and bases for the study of Zheng type of TCM and the entity of Zheng.Mehtod: CHD patients preparing to be treated with coronary angiographiy (CAG) are divided into different TCM-SDT according to "the criterion of Traditional Chinese Medicine Syndrome Differentiation" (modified in 1990) drawn up by Chinese Assocition of Integration Medicine and scored according to "the diagnostic criterion of syndrome of blood stasis" drawn up by training council of promote blood circulation to remove blood stasis. On the day of doing CAG , vein sera of patients with empty stomach were obtained and LPA was measured by biochemical colormetric assay, CD62P and PACl level was analyzed by folw cytometry assay.Results:1. CD62P level of platelet coat in CHD patient was much higher than that in the healthy control group. CD62P level of platelet coat in patient with unstable angina decubitus or unstable mixed angina or old myocardial infarction was significantly higher than that in patient with unstable tire angina or unstable spontaneous angina. CD62P level of platelet coat in patient with unstable angina or old myocardial infarction was significantly higher than that in patient with stable angina pectoris. CD62P level of platelet coat in patient with syndrome of blood stasis of Qi-Deficiency and Tin-stagnation or syndrome of blood stasis of syndrome of blood stasis of Yin Deficiency and Qi-Deficiency as well as syndrome of blood stasis of syndrome of blood stasis of Tin Deficiency and Qi-Deficiency and Heat Phlegm stagnation was significantly higher than that in patient with syndrome of blood stasis of Qi-Deficiency and Cold Phlegm stagnation. CD62P level of Platelet Coat in CHD patient withMedium-scored syndrome of blood stasis was significantly higher than that in patient with low-scored syndrome of blood stasis.2. PAC1 level of platelet coat in CHD patient was much higher than that in the healthy control group. PACl level of platelet coat in patient with unstable angina decubitus or unstable mixed angina as well as old myocardial infarction was significantly higher than that in patient with stable angina pectoris. PACl level of platelet coat in patient with medium-scored syndrome of blood stasis was significantly higher than that in patient with low-scored syndrome of blood stasis. There is no significant difference for PACl level among all patients with different zheng type of TCM. There is no significant difference for PACl level comparing CAG type group with the pathological changed numbers of coronary arteies.3. Serum LPA level of CHD patient was much higher than that in the healthy control group. Serum LPA level of patient with unstable mixed angina was significantly higher than that in patient with stable angina pectoris. Serum LPA level of patient with syndrome of blood stasis of yin deficiency and heat phlegm stagnation or syndrome of blood stasis of yang deficiency was significantly higher than that in patient with syndrome of blood stasis of qi deficiency and Cold Phlegm stagnation.4. Stable angina pectoris was mainly distributed in the patients with A-type pathological changes, most of pathological changes were belonging to single-branch pathological changes. With the increasing numbers of pathological changed branches and serious degree of the disease, the ratio of stable angina pectoris was decreased.5. Syndrome of blood stasis of qi deficiency and heat phlegm stagnation and syndrome of blood stasis of syndrome of blood stasis of Yin Deficiency and Qi-Deficiency were mostly appeared in the patients with single- or double- branch pathological changes. With the increasing of degree of Syndrome of blood stasis, the lesion of branch number of coronary artery was increased tendentiously. The syndrome of blood stasis score of CHD patients with syndrome of blood stasis of yang deficiency or syndrome of blood stasis of syndrome of blood stasis of Yin Deficiency and Qi-Deficiency and Heat Phlegm stagnation or syndrome of blood stasis of yang deficiency and Cold Phlegm stagnation was significantly higher than that in patient with syndrome of blood stasis of Qi-Deficiency and Yin-stagnation or syndrome of blood stasis of yin deficiency and Heat Phlegm stagnation as well as Qi-Deficiency syndrome of blood stasis.6. The Syndrome of blood stasis score could reflect developmentally the changes of CHD andserious degree. The lesion of branch number of coronary artery and coronary stricture in patients with Qi-Deficiency syndrome of blood stasis or yin-Deficiency syndrome of blood stasis as well as yang-Deficiency syndrome of blood stasis was increased. The syndrome of blood stasis score had the relationship with the lesion of type coronary artery . Syndrome of blood stasis was the common syndrome of superficial disease of CHD. Syndrome of Phlegm stagnation was also related with the CHD.Conclusion:1. The platelets in a CHD patient was in a activated state. Platelet coat glycoprotein CD62P could reflect the changes , development and serious degree of CHD.2. Though the PAC1 level in CHD patient was increased, it could not reflect the development of Zheng type of TCM, either to the pathological changes of CHD or the lesion of branch number coronary artery.3. Here it is the first time to useLPA level to analyze the relationship between the CHD and Zheng type of TCM. The serum LPA level could reflect the development of Zheng type of TCM of CHD patient.4. Blood stasis is characterized as the cause of disease and pathogenesis of CHD. Principl of promote Blood circulation to remove blood stasis is the basic theory to treat CHD. In the clinical tratment of CHD, principl of promote Blood circulation to remove blood stasis plus Zheng type of TCM such as promote the circulation of Qi, tonify Qi, eliminate Phlegm stagnation, tonify Yin as well as warm Yang , that is treating both Biao and Ben, may get the best result.