The Correlative Study Between P-selectin, Coronary Arteriography And TCM Syndrome Differentiation-type In Unstable Angina Pectoris

Objective:①To approach the relationship between P-selectin,high-sensitivity C-reactive protein(hs-CRP),Fibrinogen(FIB) and TCM- Syndrome Differentiation type(TCM-SDT) of Unstable Angina Pectoris(UAP).②To observe the correlation between the result of Coronary Arteriography(CAG) and TCM-SDT of UAP.③To investigate the relationship between P-selectin,hs-CRP,FIB,CAG and TCM-SDT of UAP.④Expect to provide the objective evidence for clinical TCM-SDT of UAP,To provide the new thoughts and methods of prevention and cure of UAP using way of western medicine combined with TCM.Method:1.20 normal peoples who who were satisfied with allowable standard of normal group were selected.90 patients who were satisfied with allowable standard of UAP group and were finally diagnosed by CAG were selected,The 90 patients were divided into differently dangerous degree.2.90 patients who were finally diagnosed by CAG were distinguished into five types using the way of Syndrome Differ Classification by the standard《The guided principle in clinical study of Chinese Medicine and New Medicine(Try line)2002》,These types were heart-blood stasis,Deficiency of QI and heart-blood stasis,phlegm accumulated in heart-nervure,deficiency both QI and Yin,deficiency Of YANG QI.3.Selected peoples ' Pselectin level were measured with way of enzyme linked immunosorbent assay(ELISA),Selected peoples'hs-CRP concentration were measured with immunoturbidimetry(ITM),and selected peoples 'FIB concentration were measured with magnetic bead method.4.90 patients who were finally sorted by way of Syndrome Differ Classification were selected,Patients' numbers of different CAG results which involved number of coronary artery lesion,Gensini score of coronary artery lesion,character of coronary artery lesion,form of coronary artery lesion were noted.5.The content of P-selectin,hs-CRP,FIB of numbers;Gensini scores; character;forms of different coronary artery lesion were measured.6.The content of selectedpeoples' P-selectin,hs-CRP,FIB were disposed statistically with statistical software;The results of CAG about petients of differernt TCM-SDT were disposed statistically;The content of P-selectin,hs-CRP,FIB of different results of CAG were statistically disposed with statistical software.7.The results of Selected peoples 'P-selectin,hs-CRP,FIB were analyzed,who included normal group,UAP group,UAP group of differently dangerous degree,UAP group of differernt TCM-SDT;CAG results which involved number,Gensini score,character,form of coronary artery lesion of different TCM-SDT of UAP were analyzed;The relationship among P-selectin,hs-CRP,FIB,CAG results of different TCM-SDT of UAP were analyzed.Result:1.①Serum P-selectin,serum hs-CRP and plasma FIB level of UAP patients are higher than those of normal controlled group,there are very marked differences between of them(P＜0.01).②There are very marked differences(P＜0.01) among the P-selectin,hs-CRP, FIB level of three groups UAP patients with differently danger degree.The P-selectin,hs-CRP, FIB level of three groups UAP patients with differently danger degree range:the highest danger group＞the higher danger group＞the lower danger group.③Among P-selectin,hs-CRP, FIB level of different TCM-SDT of UAP,The relationship between P-selectin and hs-CRP is positive correlation(r=0.451,P＜0.01),the relationship between P-selectin and FIB is positive correlation(r=0.383,P＜0.01),the relationship between hs-CPR and FIB is also positive correlation(r=0.261,P＜0.05).④There are very marked difference or marked difference (P＜0.01,P＜0.05) among the P-selectin,hs-CRP,FIB level of differernt TCM-SDT of UAP,The order of P-selectin concentration of differernt TCM-SDT of UAP is deficiency of QI and heart-blood stasis＞heart-blood stasis＞phlegm accumulated in heart-nervure＞deficiency both QI and Yin＞deficiency of YANG QI;There are very marked difference between Deficiency of QI and heart-blood stasis,heart-blood stasis and one syndrome type of other four types(P＜0.01),There are not marked difference among phlegm accumulated in heart-nervure,deficiency both QI and Yin and deficiency of YANG QI(P＞0.05).⑤The hs-CRP level of differernt TCM-SDT of UAP range:Deficiency of QI and heart-blood stasis＞heart-blood stasis＞phlegm accumulated in heart-nervure＞deficiency of YANG QI＞deficiency both QI and Yin;There are very marked difference between Deficiency of QI and heart-blood stasis and one syndrome type of other four types(P＜0.01),There are very marked difference between heart-blood stasis and deficiency of YANG QI(P＜0.01),deficiency both QI and Yin(P＜0.01),There is very marked difference between phlegm accumulated in heart-nervure and deficiency both QI and Yin(P＜0.01),There is marked difference between phlegm accumulated in heart-nervure and deficiency of YANG QI(P＜0.05).⑥The FIB level of differernt TCM-SDT of UAP range:Deficiency of QI and heart-blood stasis＞heart-blood stasis＞phlegm accumulated in heart-nervure＞deficiency of YANG QI＞deficiency both QI and Yin;there are very marked difference between deficiency of QI and heart-blood stasis and heart-blood stasis(P＜0.01),phlegm accumulated in heart-nervure(P＜0.01),deficiency of YANG QI(P＜0.01),deficiency both QI and Yin(P＜0.01),There are not marked difference among heart-blood stasis,phlegm accumulated in heart-nervure,deficiency of YANG QI,and deficiency both QI and Yin(P＞0.05).2.①Narrow branches of mean coronary artery lesion in differernt TCM-SDT of UAP have no marked difference(X=2.273,P＞0.05),Content of P-selectin,hs-CRP,FIB in single ramus,double rami,and complex rami of coronary artery lesion increase progressively,but there are not marked differences between the P-selectin,hs-CRP level of double rami and that of complex rami of coronary artery lesion(P＞0.05).②Gensini scores of coronary artery lesion in differemt TCM-SDT of UAP have very marked difference(X=12.599,P＜0.05).The order of Gensini score of differernt TCM-SDT in UAP ranged:deficiency both QI and Yin＞Deficiency of QI and heart-blood stasis＞deficiency of YANG QI＞heart-blood stasis＞phlegm accumulated in heart-nervure.Contents of P-selectin,hs-CRP,FIB in differernt Gensini score of coronary artery lesion have very marked difference or marked difference(P＜0.01,P＜0.05).Content of P-selectin,hs-CRP,FIB with Gensini score of three groups from high to low is group of 20-40 score,group of＜20 score,group of＞40 score.③There are not marked differences among three kinds of character of coronary artery lesion in UAP syndrome types of TCM(P=0.053,P＞0.05).Content of P-selectin,hs-CRP,FIB about A type of coronary artery lesion is the highest,the second is B type,the third is C type.There are very marked difference or marked difference among P-selectin,hs-CRP,FIB level of differemt character of coronary artery lesion(P＜0.01,P＜0.05).④There are very marked differences among form of coronary artery lesion in five kinds of TCM-SDT in UAP (P=0.001,P＜0.01).There are very marked differences among content of P-selectin,hs-CRP,FIB in three kinds of different form of coronary artery lesion(P＜0.01).Content of P-selectin,hs-CRP,FIB of three kinds of different form in coronary artery lesion range:Ⅱtype＞Ⅰtype＞Ⅲtype.Conclusion:①P-selectin may be as one of tested index reflecting severe degree of UAP.②Contents of P-selectin,hs-CRP,FIB have refered value for Syndrome Differ Classification of UAP,It is explained the three inflamed markers have closed relationship with differemt TCM-SDT of UAP,especially with blood stasis syndrome,phlegm syndrome,which is mainly excess syndrome,they conduce to estimate severe degree of pathogenetic condition.③What to be done in diagnosing correctly severe degree of UAP need estimate synthetically branch,narrow degree,character and form of coronary artery lesion.④The relationship that is analyzed among inflammatory marker,Coronary Arteriography and TCM-SDT of UAP provide objective evidence and new thoughts and methods for clinical diagnosis and treatment of UAP.