The Study About The Relationship Between Phlegm-blood Stasis Syndrome Of Coronary Heart Disease And The Serum Level Of C-reactive Protein (CRP) E-selectin And CRP1059G/C E-selectin G98T S128R Polymorphism

Backgroud: CHD is belonged to the "Xin Tong" in traditional Chinesemedicine, of which pathogenesis is deficiency of Ben and repletion of Biao.Neoteric TCM doctors believe the repletion of Biao can be descried asturbid phlegm, blood-stasis, cold and so on, phlegm-blood stasis is thebasic pathogenic change. Phlegm-blood stasis syndrome is the commonsyndrome of CHD. At present the prevention and treatment of CHD beginsfrom the information of atherosclrosis, interferes with the inflammationcell factors, abnormality of blood lipid and the information of thrombus.The genetic epidemiology study shows that genetics paly an important rolein the information of CHD. We find some genetic polymorphisms which haveclose relationship with the risk increase of CHD information, influencethe pathological and physiological course of CHD, such as the metabolismof blood lipid, the inflammatory response, the information of thrombus,vasal constriction and dilation, and so on. However, there are fewresearches about the relationship between the phlegm-blood stasissyndrome of CHD and the level of inflammation factor and theirpolymorphism, the essence of phlegm-blood stasis syndrome of CHD shouldneed further research.Objective: To investigate the essence of phlegm-blood stasissyndrome of CHD in the aspect of polymorphism. Find the differences among the different syndromes of CHD about the level of serumCRP, E-selectin and their polymorphisms, at the same time, compare the CHDwith acute cerebral thrombosis(CT) which they have the same syndrome(phlegm-blood stasis )at the level of inflammation factors and theirpolymorphism.Method: Divide the CHD patients into three groups: phlegm-bloodstasis syndrome group, blood-stasis syndrome group and turbid phlegmsyndrome group. Set up normal group and regard the phlegm-blood stasissyndrome of cerebral thrombosis as control group. Detect the serum levelof CRP, E-selectin, and the 1059G/C polymorphism of CRP and G98T/S128Rpolymorphism of E-selectin were screened by PCR-RFLP. At the sametime, detect the level of serum lipid such as (TG, CHOL, LDL-C, HDL-C,ApoA and ApoB) among these groups. Analyse the differences of the aboveindexes among the groups of normal group, control group, the phlegm-bloodstasis syndrome of CHD, the blood stasis syndrome of CHD, and turbid phlegmsyndrome of CHD.Result: The serum level of CRP and sE-selectin have different degreerising among the different syndrome groups of CHD (the phlegm-blood stasis＞the turbid phlegm＞the blood-stasis). they have significant differencescomparing with normal group(P＜0.05), but there is no significantdifference among them(P＞0.05).GC/CC genotype and C allele frequencies ofCRP1059G/C in the phlegm-blood stasis of CHD is higher than normal group,so are GG /SR genotype and G/R allele frequencies of E-selectin in thephlegm-blood stasis of CHD, but there is no significant difference withthe statistics analysis. Increased TG, LDL-C, CHOL and APOB and reducedHDL-C, APOA are easy to find in the phlegm-blood stasis syndrome of CHDgroup, especially the changes in TC and LDL-C are much more obvious, theseindexes have significant differences comparing with the normal groupexcept HLD-C, there is no difference among the syndromes of CHD(P＞0.05).The phlegm-blood stasis syndrome of CHD group, comparing with thephlegm-blood stasis syndrome of CT, has some difference at the level ofTG, APOA, CRP, but has no statistical difference of sE-selectin level andpolymorphism(P＞0.05).Conclusion:1. The phlegm-blood stasis syndrome is main syndrome of CHD, the increase of TG, LDL-C, CRP and sE-selectin can be regarded as the referenceindexes for the differentiation of the phlegm-blood stasis syndrome ofCHD.2. The phlegm-blood stasis syndrome of CHD may have some relationshipwith C allele of CRP1059G/C,G allele of E-selectin G98T and R allele ofE-selectin S128R.3. The phlegm-blood stasis syndrome of CT compares with thephlegm-blood stasis syndrome of CHD in the level of plasm lipidinflammatory factors and the gene ploymorphsims, we find thedismetabolism of plasm lipid and increase of inflammatory factors levelwith different degree between them, there is the difference of TG, APOA,CRP between them (P＜0.05), but we find no difference of sE-selectin andinflammation factors' gene polymorphoism between them.