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目的 :研究单纯性高甘油三酯血症辨证分型与自由基代谢及凝血纤溶活性的关系。方法 :选择血清甘油三酯 >1.8mm ol/ L患者 ,按中医辨证分为气虚证组 (2 5例 )、阴虚证组 (2 6例 )、阳虚证组 (2 0例 )、痰湿证组 (2 4例 )和血瘀证组 (2 5例 ) ,并设立对照组 (2 5例 ) ,比较各组血浆丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH Px)、内皮素 (ET)、一氧化氮 (NO)、血小板α颗粒膜蛋白 (GMP 14 0 )、组织型纤溶酶原激活剂 (t PA)及其抑制剂 (PAI)等指标的差异。结果 :高甘油三酯血症各证型 ET、MDA、PAI、GMP 14 0均高于对照组 ,而 NO、SOD、GSH Px、t PA均较之为低 (P均 <0 .0 1) ;痰湿证组、血瘀证组 ET、MDA、PAI、GMP 14 0、SOD、GSH Px均高于气虚证组、阴虚证组与阳虚证组 ,而 NO、t PA则较低 (P均 <0 .0 1) ;阳虚证组 SOD、GSH Px则较气虚证组与阴虚证组显著降低 (P均 <0 .0 1)。结论 :各证型均存在不同程度的自由基代谢紊乱及凝血纤溶系统的改变 ,痰湿证及血瘀证存在较明显脂质过氧化反应增强、血管内皮细胞功能障碍、血小板活化、纤溶活性降低等改变 ,阳虚证组抗氧化酶活性降低。
Objective: To study the relationship between syndrome differentiation of simple hypertriglyceridemia and free radical metabolism and coagulation fibrinolytic activity. Methods: The patients with serum triglyceride> 1.8mmol / L were divided into Qi deficiency syndrome group (25 cases), Yin deficiency syndrome group (26 cases), Yang deficiency syndrome group (20 cases) and sputum phlegm (24 cases) and blood stasis syndrome group (25 cases). The control group (25 cases) was established. The plasma levels of malondialdehyde (MDA), superoxide dismutase (SOD) (GSH Px), endothelin (ET), nitric oxide (NO), platelet α-granule membrane protein (GMP 14 0), tissue-type plasminogen activator (t PA) Inhibitor (PAI) and other indicators of the difference. Results: The levels of ET, MDA, PAI and GMP14 in hypertriglyceridemia were all higher than those in control group, while the levels of NO, SOD, GSH Px and t PA were lower (P <0.01) ; The levels of ET, MDA, PAI, GMP 14 0, SOD and GSH Px in phlegm-dampness syndrome and blood-stasis syndrome were higher than those in qi deficiency syndrome, yin deficiency syndrome and yang deficiency syndrome, while NO and t PA were lower P <0.01). The levels of SOD and GSH Px in yang deficiency syndrome group were significantly lower than those in qi deficiency syndrome and yin deficiency syndrome group (all P <0.01). Conclusion: There are different levels of free radical metabolism and changes of coagulation and fibrinolysis system in different syndromes. There is obvious increase of lipid peroxidation in phlegm dampness syndrome and blood stasis syndrome, vascular endothelial cell dysfunction, platelet activation, fibrinolysis Activity decreased and other changes, Yang Deficiency group decreased antioxidant enzyme activity.