Study Of Correlation Between Serum Adiponectin And The Severity Of Coronary Lesions And TCM Syndrome Type In Patients With Coronary Heart Disease

Objective: Observe the correlation between serum adiponectinand the severity of coronary lesions in patients with coronary heartdisease and TCM syndrome type of coronary heart disease，To explorethe objective index of differentiation of TCM syndrome type of coronaryheart disease. Methods: Choosed66patients who were diagnosed bycoronary angiography for coronary heart disease randomly. There were40males,26females, age48-88years old, the average age of (67.65±10.65), Including27smokers,44patients with hypertension,9patientswith diabetes mellitus. These patients were divided into different groupsaccording to coronary lesion counts from the results of CAG and differentTCM syndromes; In addition, collected18cases considered CHD by thedoctor from outpatient service, but did not see coronary stenosis in theCAG. There were11males,7females, age44-86, mean age (65.83±11.25) years old, accompaning by the following:5smokers,11cases ofessential hypertension,2patients with diabetes mellitus. Detected thecontents of serum APN in all the patients, and compared generalinformation, serum APN levels between patients with CHD and non CHD,the groups with different coronary artery lesion, different TCM syndrome types, and the distribution of the severity of coronary artery lesion indifferent TCM syndrome types.1.Choosed66patients with coronaryheart disease who wewe conformed to the diagnosis standard, andexcluded the patients who didn’t meet the criteria or didn’t have completedata.2. Recorded these patients’ general information such as age, gender,body mass index, smoking history, history of hypertension, diabetes, andcoronary angiography results. These patients were divided into singlelesion20cases, the double branch lesion28cases,18patients withmultivessel lesions according to the coronary artery lesion counts showedin the results of CAG; With reference to the TCM syndrome diagnosticcriteria of thoracic obstruction in2002"guiding principle of clinicalresearch on new drugs of TCM", these patients were divided into4groups: TCM Syndromes of blood stasis syndrome22cases, patients withsyndrome of phlegm blocking heart vessel in15cases, Yang Qideficiency syndrome in15cases,14cases of deficiency of both Qi andYin. Seted up a control group of18cases of non CHD, to compare thedifference of serum adiponectin level between CHD group and nonCHD group.4. All hospitalized patients were extracted fasting venousblood4ml the next morning, collected serum by centrifugation, andstored it in low temperature.5. Determination of APN content: detectedthe APN content by ELISA and compared it, observed the correlationbetween APN and the severity of coronary artery lesion and TCM syndrome type of CHD.6. Data collecting, sorting and analysis: All dataswere first recorded in Excel electronic form and then analyzed withSPSS19.0software package. Measurement data was showed by mean±standard deviation. Mean comparison between two groups used twoindependent sample t test.Mean differences among multiple groupscompared with F test firstly, when the difference was statisticallysignificant, q test was applied to multiple comparisons; Count data usedX2test, When R×C contingency table cell theoretical frequency is toosmall (about1/5cell theoretical frequency is less than5or more than1cell theoretical frequency is less than1), used the Fisher exact probabilitymethod; grades count data used Kruskal-Wallis H. P>0.05, no significantdifference; p <0.05,there were statistical differences; p<0.01,there weresignificant differences. Results:1.The comparetions of age, sex, bodymass index, smoking history, history of hypertension, diabetes betweenCHD group and non CHD group, the coronary lesion groups, differentTCM syndrome types, in addition to qi and Yin deficiency syndromebody mass index was lower than other syndrome types, were nostatistically significant differences (p>0.05). Each group of data wascomparable.2.Serum APN content of CHD group (15.21±5.96) ug/mlwas lower than the control group （26.14±6.18）ug/ml, the differencewas statistically significant (p<0.01).3.Analysis of CHD patientsserum APN and coronary artery lesion count showed a correlation: non CHD group（26.14±6.18）ug/ml> single vessel disease group (19.58±4.82) ug/ml> double vessel lesion group (14.83±5.85) ug/ml> multivessel disease group (11.16±4.38) ug/ml,the difference was statisticallysignificant (p<0.05or p<0.01).4.Each type of TCM Syndromes patients’serum APN levels: blood stasis syndrome (17.60±6.91) ug/ml, phlegmblocking heart vessel syndrome (11.31±4.82) ug/ml, Yang Qi deficiencysyndrome (17.59±4.61) ug/ml, both Qi and yin deficiency syndrome(13.36±4.47) ug/ml, the content of serum APN in different syndrometypes were lower than non CHD group, the difference was statisticallysignificant (p<0.01); The content of serum APN in phlegm blocking heartvessel syndrome and Qi and yin deficiency syndrome were lower thanthat of blood stasis syndrome and yang qi deficiency syndrome group, thedifference was statistically significant (p<0.01or p<0.05); The content ofserum APN was no statistically significant difference between phlegmblocking heart vessel syndrome and Qi and yin deficiency syndrome(p>0.05);At the same time, the serum APN content between bloodstagnation syndrome and yang qi deficiency syndrome had no statisticalsignificance (p>0.05). In different TCM syndrome types of CHD, thecoronary artery lesions between blocking heart vessel syndrome and Qiand yin deficiency syndrome was given priority to double and multibranch distribution,but coronary pathological change in Blood stasissyndrome and yang qi deficiency syndrome was given priority to single and double branch distribution (p <0.01). Conclusions:1Serumadiponectin in CHD was significantly lower than that in non CHDpatients,with the increasing number of diseased coronary artery, serumAPN decreased gradually. The results suggested that detection of serumAPN, can predict the presence of CHD and coronary artery lesion scopeto a certain extent.2The serum APN levels in each TCM syndromeswere significantly lower than those in the control group, and there weredifferences between different TCM Syndromes of serum APN content.The levels of serum APN in Syndrome of phlegm blocking heart vesseland qi and yin deficiency syndrome were lower than blood stasissyndrome and yang qi deficiency syndrome. APN is likely to becomeone of the objective indexes of TCM Syndromes of CHD.3. The degreeof coronary artery lesions differed in different TCM syndrome types, thecoronary artery lesions between blocking heart vessel syndrome and Qiand yin deficiency syndrome was given priority to double and multibranch distribution,but coronary pathological change in Blood stasissyndrome and yang qi deficiency syndrome was given priority to singleand double branch distribution,combining serum APN and CAG resultswill be more conducive to differ TCM syndromes of CHD.