Relationship Between The Extent Of Coronary Artery Stenosis With The Levels Of Hcy And The Syndromes Of TCM In Coronary Heart Disease

Objective:To explore the relationship between the plasma homocysteine(Hcy) and the degree of coronary artery disease.To explore relationship between the extent of coronary artery stenosis with the Levels of Hcy and the Syndromes of TCM in Coronary Heart Disease,as to provide some objective basis for prevention and treatment of CHD in TCM and Western Medicine.Methods:There are 100 patients who have been diagnosed CHD by coronary artery imaging(CAG) and 25 cases of normal control group.Enzymatic detection of circulating levels of plasma Hcy.100 patients who have been diagnosed CHD by coronary artery imaging(CAG) were divided into One-artery lesion,two-artery lesion and three-artery lesion according to the number of coronary artery disease.The patients with CHD were also divided into Gensini score＜20 group,Gensini score of 20 to 40 group and Gensini score＞40 group by Gensini score of coronary artery lesion.All patients according to TCM standards of coronary heart disease were divided into:Syndrome of cariac blood stasis,Syndrome of phlegm obstructing heart meridian,Syndrome of YIN-cold stagnant, Syndrome of deficiency of both vital energy and YIN,Syndrome of YIN deficiency of heart and kidney,Syndrome of YANG QI.deficient.Patient's fasting plasma tHcy was measured.To analyze the correlation between the number of coronary artery disease and plasma Hcy,the degree of coronary stenosis and plasma Hcy,TCM syndrome and the number of coronary artery disease,TCM syndrome and the degree of coronary stenosis,TCM syndrome and plasma Hcy.Results:1.The Hcy concentration of CHD group(21.72±5.13umol/L)was obviously higher than that of normal group(7.88±4.06umol/L)(P＜0.01).①According to the number of coronary artery branch:One-artery lesion group(17.83±4.04umol/L)＜two-artery lesion group(22.22±4.27umol/L)＜three-artery lesion group(24.50±4.86umol/L).Single-vessel disease group was significantly lower than double-vessel group and three lesions(all P＜0.01).②According to Gensini score of coronary artery lesion:Gensini score＜20 group(16.78±3.46umol/L)＜Gensini score of 20 to 40 group(21.14±4.00umol/L)＜Gensini score＞40 group(24.74±4.97umol/L) (both P＜0.01).2,①From the TCM Syndrome Types:Syndrome of cariac blood stasis(25.83±5.47umol/L),Syndrome of phlegm obstructing heart meridian(19.53±4.56umol/L),Syndrome of YIN-cold stagnant(22.00±4.55umol/L), Syndrome of deficiency of both vital energy and YIN(18.06±1.98μmol/L),Syndrome of YIN deficiency of heart and kidney(21.13±2.80umol/L),Syndrome of deficient and weak YANG QI(22.15±5.70umol/L)and there plasma tHcy levels were significantly higher than the normal control group(all P＜0.01).Plasma tHcy levels of syndrome of cariac blood stasis were significantly higher than syndrome of phlegm obstructing heart meridian,syndrome of YIN-cold stagnant,syndrome of deficiency of both vital energy and YIN,syndrome of YIN deficiency of heart and kidney(P＜0.01),syndrome of deficient and weak YANG QI(P＜0.05).②Relationship between TCM syndrome and the number of coronary artery disease:There were significant differences in the distribution of coronary artery lesion number among different TCM Syndrome groups(P＜0.01). Syndrome of cariac blood stasis group three-artery lesion accounted for(60.9%),Syndrome of phlegm obstructing heart meridian group three-artery lesion accounted for(13.4%),Syndrome of YIN-cold stagnant group three-artery lesion accounted for(43.7%),Syndrome of deficiency of both vital energy and YIN group three-artery lesion accounted for(11.8%),Syndrome of YIN deficiency of heart and kidney group three-artery lesion accounted for(31.3%),Syndrome of deficient and weak YANG QI group three-artery lesion accounted for(30.8%).Syndrome of cariac blood stasis group effort ratio of the three lesions was significantly higher than other card-type group(P＜0.05).③There were significant differences in the Gensini score of coronary artery lesion among different TCM Syndrome groups(P＜0.01).Syndrome of cariac blood stasis group effort Gensini score(48.65±22.45) was significantly higher than Syndrome of phlegm obstructing heart meridian group(29.33±12.40),Syndrome of YIN-cold stagnant group(31.44±16.82),Syndrome of deficiency of both vital energy and YIN (25.12±15.74)(all P＜0.01),Syndrome of YIN deficiency of heart and kidney group (34.19±14.51) and Syndrome of deficient and weak YANG QI group(36.31±16.21)(P＜0.05).Conclusion:1.Levels of plasma Hcy CHD patients are significantly higher than that of normal group.Plasma Hcy correlated with CHD coronary lesion count and severity of stenosis.Whether or not with coronary artery plaque stability has nothing to do.2.TCM syndrome count with the number of coronary artery disease.TCM syndrome count with the degree of coronary stenosis.The relationship between the number of coronary artery disease with the degree of coronary stenosis and TCM syndrome,Syndrome of cariac blood stasis is the most closely.3.There were significant differences in the Levels of plasma Hcy among different TCM Syndrome groups.The relationship between TCM syndrome and plasma Hcy,Syndrome of cariac blood stasis is the most closely.The level of Homocysteine provided the base for coronary heart disease syndrome differentiation.