Objective To analyze the characteristics of coronary heart disease in the peri-menopausal women with qi deficiency and blood stasis syndrome.Methods Totally 226 peri-menopausal women aged 40-55 years old with coronary heart disease from December 2012 to December 2013 were enrolled and divided into observation group with qi deficiency and blood stasis syndrome and control group without qi deficiency and blood stasis syndrome.The fasting blood glucose,triglyceride,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,very low density lipoprotein cholesterol,apolipoprotein A1,apolipoprotein B,lipoprotein (a),alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transferase,serum total protein,albumin,urea nitrogen,creatinine,uric acid,C reactive protein,α-amylase,fibrinogen,blood routine test (red-cell count,hemoglobin,hematocrit,mean corpuscular hemoglobin) and echocardiography (left atrial diameter,left ventricular end diastolic diameter,interventricular septum thickness,left ventricular posterior wall thickness,left ventricular ejection fraction) were measured and compared between the two groups.Results In control group,the age was (48.8 ± 1.8) years old,49 cases had diabetes,54 cases had hyperlipidemia,42 cases had hypertension,79 cases had angina pectoris and 11 cases had myocardial infarction.In observation group,the age was (48.5 ± 2.5) years,51 cases had diabetes,58 cases had hyperlipidemia,45 cases had hypertension,77 cases had angina pectoris and 9 cases had myocardial infarction.Above baseline data were not statistically different between the two groups (all P ＞ 0.05).The fasting blood glucose,triglyceride,very low density lipoprotein cholesterol in observation group were significantly higher than those in control group [(7.3 ± 3.5) mmol/L vs (6.0 ± 2.1) mmol/L,(2.1-± 1.2) mmol/L vs (1.8 ± 1.0) mmol/L,(1.1 ± 0.6) mmol/L vs (0.6 ± 0.4) mmol/L],the high density lipoprotein cholesterol,α-amylase,hematocrit and mean corpuscular hemoglobin were significantly lower than those in control group [(1.1 ± 0.3) mmoL/L vs (1.2 ± 0.5) mmol/L,(39 ± 18) U/L vs (53 ±-20) U/L,(37 ± 3)％ vs (40±4)％,(29.8±1.7)pgvs (31.5±2.8)pg](P＜0.05).Conclusion Theperi-menopausalpatients of coronary heart disease with qi deficiency and blood stasis syndrome are more susceptible to glucose and lipid metabolism disorder compared with those without qi deficiency and blood stasis syndrome.%目的 分析气虚血瘀型围绝经期冠状动脉粥样硬化性心脏病(冠心病)患者的临床特点.方法 选取2012年12月至2013年12月于首都医科大学附属北京安贞医院就诊和住院的年龄40 ～ 55岁处于围绝经期的女性冠心病患者226例,按照中医辨证是否合并气虚血瘀证分为观察组(气虚血瘀患者,113例)和对照组(非气虚血瘀患者,113例).采集患者生化(空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B、脂蛋白a、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、血清总蛋白、清蛋白、尿素氮、肌酐、尿酸、C反应蛋白、α-淀粉酶、纤维蛋白原)、血常规(红细胞计数、血红蛋白、血细胞比容、平均红细胞血红蛋白量)和超声心动图(左心房内径、左心室舒张末期内径、室间隔厚度、左心室后壁厚度、左心室射血分数)指标,比较2组患者各项指标的差异.结果 对照组平均年龄(48.8±1.8)岁,糖尿病49例,高脂血症54例,高血压42例,心绞痛79例,心肌梗死11例;观察组平均年龄(48.5±2.5)岁,糖尿病51例,高脂血症58例,高血压45例,心绞痛77例,心肌梗死9例,2组基线资料比较,差异均无统计学意义(均P ＞0.05).与对照组比较,观察组空腹血糖、三酰甘油、极低密度脂蛋白胆固醇明显升高[(7.3±3.5) mmol/L比(6.0±2.1) mmol/L,(2.1±1.2) mmol/L比(1.8±1.0) mmoL/L,(1.1±0.6) mmol/L比(0.6±0.4) mmol/L],高密度脂蛋白胆固醇、α-淀粉酶、血细胞比容、平均红细胞血红蛋白量明显降低[(1.1 ±0.3) mmol/L比(1.2±0.5) mmol/L,(39±18)U/L比(53 ±20) U/L,(37±3)％比(40±4)％,(29.8±1.7)pg比(31.5±2.8)pg],差异有统计学意义(P＜0.05),2组患者其他各项指标比较,差异均无统计学意义(均P＞0.05).结论 气虚血瘀型围绝经期冠心病患者较非气虚血瘀型患者更易出现糖脂代谢紊乱.
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