摘要
目的:探究2型糖尿病合并稳定型心绞痛(T2DM-SAP)患者中医证型特点及与血清微小RNA-33a(miR-33a)、炎性标志物和预后的关系。方法:纳入2021年11月~2022年11月期间本院收治的T2DM-SAP患者119例,依据临床症状、脉搏等对T2DM-SAP患者进行中医辨证,回顾性收集不同证型患者相关临床资料。比较不同证型T2DM-SAP患者的血清miR-33a表达、炎性标志物[降钙素原(PCT)、同型半胱氨酸(Hcy)及血清超敏C反应蛋白(hs-CRP)]水平及预后情况[中重度心血管不良事件(全因死亡,心肌梗死再入院或脑卒中复发)、轻度(短暂性脑缺血发作与心绞痛再入院)]。结果:119例T2DM-SAP患者临床主要有4种证型分布,包括气虚血瘀证38例(31.93%)、痰瘀互结证34例(28.57%)、气阴两虚证25例(21.01%)、阴阳两虚证22例(18.49%);4种证型患者的血清miR-33a表达、PCT、Hcy以及hs-CRP水平比较,气虚血瘀证、痰瘀互结证均高于其他2种证型(P<0.05),且痰瘀互结证高于气虚血瘀证(P<0.05);预后情况比较,痰瘀互结证心血管不良事件总发生率均高于其他3种证型(P<0.05),而气阴两虚证、气虚血瘀证、阴阳两虚证之间比较无统计学差异(P>0.05)。结论:T2DM-SAP患者临床常见中医证型包括气虚血瘀证、痰瘀互结证、气阴两虚证以及阴阳两虚证,且不同证型患者之间的预后情况、血清miR-33a表达及炎性标志物水平存在差异。
Objective:To explore the relationship between TCM syndrome type and serum miR-33a,inflammatory markers and prognosis in T2DM-SAP patients.Methods:A total of 119T2DM-SAP patients admitted to our hospital from November 2021to November 2022were included.TCM syndrome differentiation of T2DM-SAP patients was performed according to clinical symptoms and pulse,and relevant clinical data of patients with different syndrome types were retrospectively collected.To compare the expression of serum miR-33a,levels of inflammatory markers[procalcitonin(PCT),homocysteine(Hcy)and serum hypersensitive C-reactive protein(hs-CRP)]and prognosis of patients with different syndromes of T2DM-SAP[moderate to severe cardiovascular adverse events(all-cause death,Myocardial infarction readmission or stroke recurrence),mild(transient ischemic attack and angina pectoris readmission)].Results:Among the 119T2DM-SAP patients,there were four types of clinical distribution,including 38cases(31.93%)of qi deficiency and blood stasis,34cases(28.57%)of phlegm-stasis interformation,25cases(21.01%)of qi deficiency and 22cases(18.49%)of yin-yang deficiency.The serum miR-33a expression,PCT,Hcy and hs-CRP levels of the four syndrome types were higher than those of the other two syndrome types(P<0.05),and the syndrome of phlegm and blood stasis was higher than that of Qi deficiency and blood stasis(P<0.05).Compared with the prognosis,the total incidence of adverse cardiovascular events in the syndrome of phlegm-stasis interjunction was higher than that of the other three types(P<0.05),but there was no statistical difference between the syndrome of Qi-yin deficiency,Qi-blood stasis syndrome and yin-yang deficiency syndrome(P>0.05).Conclusion:Common TCM syndrome types in T2DM-SAP patients include qi deficiency and blood stasis syndrome,phlegm-stasis interjunction syndrome,qi Yin deficiency syndrome and Yin and Yang deficiency syndrome,and there are differences in prognosis,serum miR-33a expression and inflammatory marker levels among patients with different s
作者
张甲龙
冯丽娟
延欢欢
ZHANG Jialong;FENG Lijuan;YAN Huanhuan(Department of Clinical Laboratory,People's Hospital of Tongchuan,Tongchuan Shaanxi 727000,China;Department of Clinical Laboratory,Tongchuan Mining Bureau Central Hospital,Tongchuan Shaanxi 727000,China)
出处
《四川中医》
2024年第12期6-9,共4页
Journal of Sichuan of Traditional Chinese Medicine
