| Objective: In this study,medical records of patients with unstable angina(UA)were collected for retrospective investigation and statistical analysis.With the guidance of traditional Chinese medicine theory,Fibrinogen to albumin ratio was discussed.FAR),C-reactive protein to albumin ratio(CAR),reactive protein(a)[Lipoprotein(a),Lp(a)] and UA patients have different levels of TCM syndromes.To explore the relationship between FAR,CAR,Lp(a)and the TCM syndrome type of UA and the severity of coronary artery disease,so as to provide a certain reference for the clinical prevention and treatment of coronary heart disease by Chinese and Western medicine of UA.Method: A total of 255 patients with definite unstable angina pectoris and initial coronary angiography in the Cardiovascular Department of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2020 to December 2022 were included in the retrospective study.Data such as gender,age,height,weight,Lp(a),fibrinogen,C-reactive protein,albumin,past history and traditional Chinese medicine diagnosis were collected,BMI,FAR and CAR ratios were calculated,records and images of coronary angiography surgery were reviewed,and Gensini scores were calculated according to the results of coronary angiography.SPSS27.0 software was used to conduct statistical analysis to explore the correlation between FAR,CAR,Lp(a)and UA syndrome types of traditional Chinese medicine and the degree of coronary artery lesions.Results:1.In this study,255 cases of unstable angina pectoris of coronary heart disease were divided into 5 syndrome types.The distribution of TCM syndrome types was as follows: syndrome of phlegm-stasis interaction(31.76%)> syndrome of blood blood stasis(25.49%)>syndrome of Qi deficiency and blood stasis(17.25%)> syndrome of qi deficiency and blood stasis(15.29%)> deficiency of Qi and Yin >deficiency of heart and kidney Yang(10.20%).There were statistical differences among all types of unstable angina pectoris(P < 0.05).The age of heart-kidney Yang deficiency syndrome and Qi Yin deficiency syndrome was higher than that of phlegm-stasis mutual obstruction syndrome,blood blood stasis syndrome,qi deficiency and blood stasis syndrome(P < 0.05).There was no difference in age among the other types of syndrome.In the gender study of different syndrome types,the male patients with phlegm-stasis interaction syndrome and blood-blood stasis syndrome were significantly more than the female patients,while the female patients with Qi and Yin deficiency syndrome were more than the male patients.2.There were statistical differences in FAR,CAR,Lp(a)levels among different syndrome types(P < 0.05).The FAR level of phlegm-stasis interobstruction syndrome was higher than that of blood blood stasis syndrome,Qi deficiency and blood stasis syndrome,and Qi and Yin deficiency syndrome(P < 0.05),but had no statistical significance with heart-kidney Yang deficiency syndrome(P > 0.05).CAR level in phlegm-stasis interobstruction syndrome was higher than that in blood blood stasis syndrome,qi deficiency and blood stasis syndrome,heart-kidney Yang deficiency syndrome and Qi Yin deficiency syndrome(P < 0.05).Lp(a)level was higher in the syndrome of phlegm-stasis interaction than in the syndrome of blood blood stasis,qi deficiency and blood stasis,heart-kidney Yang deficiency(P < 0.05),but had no statistical significance compared with the syndrome of Qi and Yin deficiency(P > 0.05).3.There were statistical differences in Gensini scores among different syndrome types(P < 0.05).The Gensini scores of phlegm-stasis interaction syndrome were higher than those of Qi deficiency and blood stasis,blood blood stasis,Qi Yin deficiency and heart-kidney Yang deficiency(P < 0.05),but there was no significant difference among other syndrome types(P > 0.05).There were significant differences in BMI level,among which the BMI level was higher in syndrome of phlegm-stasis interaction than in syndrome of blood blood stasis,syndrome of qi deficiency and blood stasis,syndrome of heart-kidney Yang deficiency and syndrome of Qi and Yin deficiency(P < 0.05).4.There were statistical differences in FAR,CAR and Lp(a)among different lesion numbers(P < 0.05),and the levels of FAR,CAR and Lp(a)in the three-vessel lesion group were higher than those in single-vessel lesion and double-vessel lesion(P < 0.05).5.FAR,CAR,Lp(a)levels were correlated with the degree of coronary artery stenosis in unstable angina pectoris.Spearman linear correlation analysis showed that FAR,CAR,Lp(a)were positively correlated with Gensini scores(P < 0.05).6.The results of bivariate logistic regression analysis showed that FAR,CAR and Lp(a)were the influencing factors for the group with high scores of coronary lesions(FAR: OR=1.225,95%CI: 1.076-1.396,P=0.002;CAR: OR=1.102,95%CI: 1.076～1.396,P < 0.001;Lp(a):OR=1.006,95%CI: 1.006～1.008,P < 0.001).7.FAR,CAR and Lp(a)levels have certain predictive value for the three vessel lesions of unstable angina pectoris of coronary heart disease.ROC curve was used to predict the three vessel lesions of unstable angina pectoris of coronary heart disease with FAR,CAR and Lp(a).The area under the curve of FAR was 0.754 and the area under the curve of CAR was 0.602.The area under the curve of Lp(a)is 0.788.The results suggested that Lp(a)and FAR values had predictive value for the three branches of angina pectoris,and LP(a)had the highest predictive value.Conclusion:1.There are differences between age and gender in the distribution of TCM syndrome types of unstable angina pectoris.2.There are differences in FAR,CAR and Lp(a)of patients with unstable angina pectoris of different TCM syndrome types.FAR,CAR and Lp(a)levels of unstable angina pectoris syndrome were the highest.3.There were differences in FAR,CAR and Lp(a)of patients with unstable angina pectoris of different TCM syndrome types.Phlegm-stasis syndrome of unstable angina pectoris had the highest FAR,CAR and Lp(a)levels.4.FAR and Lp(a)have good clinical predictive value in the evaluation of the three branches of unstable angina pectoris. |
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