Pei Qiang, Sang Wen-Feng, Zhao Xi-De
Department of Integrative Medicine, First Affiliated Hospital of Xinxiang Medical College, Henan (453100), China.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Feb;33(2):186-90.
To investigate the changes of serum levels of chitinase-3-like-1 protein (YKL-40) and high-sensitivity C-reactive protein (hs-CRP) in patients with non-ST segment elevation acute coronary syndrome (ACS), to explore its correlation with its severity, and to observe the effects of Guizhi Fuling Decoction (GFD) on levels of blood lipids, YKL-40, and hs-CRP.
Recruited were 72 patients with unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI) at Department of Integrative Medicine, First Affiliated Hospital of Xinxiang Medical College from August 2010 to June 2011. They were randomly assigned to the treatment group (36 cases) and the control group (36 cases). All patients were treated by routine treatment, but patients in the treatment group took GFD additionally. The course of treatment was four weeks. According to the severity degree, all patients were graded to four ranks: low-risk group of UA, medium-risk group of UA, high-risk group of UA, and NSTEMI. The levels of YKL-40 and hs-CRP, and the correlation of severity degree were analyzed. Before and after treatment levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were measured. Before treatment, at two weeks, and after treatment the serum levels of YKL-40 and hs-CRP were detected. The relationship of YKL-40, hs-CRP and the severity of the disease were analyzed.
Levels of YKL-40 and hs-CRP were positively correlated with the severity of the disease respectively (r = 0.729, P < 0.05; r = 0.655, P < 0.05). The positive correlation also existed between YKL-40 and hs-CRP (r = 0.848, P < 0.05). There was no statistical difference in the levels of blood lipids, YKL-40, or hs-CRP between the two groups before treatment (P > 0.05). Compared with before treatment, the levels of YKL-40 and hs-CRP significantly decreased in both groups after two weeks of treatment (P < 0.05). The levels of TG, TC, LDL-C, YKL-40, and hs-CRP significantly decreased, while the HDL-C level increased in both groups after treatment (P < 0.05). The level of HDL-C in the treatment group was higher, while levels of YKL-40 and hs-CRP were lower after treatment, when compared with the control group (all P < 0.05).
On the basis of anti-inflammation and adjusting blood lipids by Western medicine, GFD could further reduce the serum levels of YKL-40 and hs-CRP of ACS patients, elevate the HDL-C level, and play anti-atherosclerosis effects.
探讨非ST段抬高型急性冠状动脉综合征（ACS）患者血清几丁质酶-3样-1蛋白（YKL-40）及高敏C反应蛋白（hs-CRP）水平变化，及其与病情严重程度的相关性，并观察桂枝茯苓汤（GFD）对血脂、YKL-40及hs-CRP水平的影响。
选取2010年8月至2011年6月新乡医学院第一附属医院中西医结合科收治的72例不稳定型心绞痛（UA）或非ST段抬高型心肌梗死（NSTEMI）患者。将其随机分为治疗组（36例）和对照组（36例）。所有患者均接受常规治疗，但治疗组患者加服GFD。疗程为4周。根据病情严重程度将所有患者分为4级：UA低危组、UA中危组、UA高危组及NSTEMI组。分析YKL-40及hs-CRP水平及其与病情严重程度的相关性。治疗前后测定甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平。治疗前、治疗2周时及治疗后检测血清YKL-40及hs-CRP水平。分析YKL-40、hs-CRP与疾病严重程度的关系。
YKL-40及hs-CRP水平分别与疾病严重程度呈正相关（r = 0.729，P < 0.05；r = 0.655，P < 0.05）。YKL-40与hs-CRP之间也呈正相关（r = 0.848，P < 0.05）。两组治疗前血脂、YKL-40或hs-CRP水平比较，差异无统计学意义（P > 0.05）。与治疗前比较，两组治疗2周后YKL-40及hs-CRP水平均显著降低（P < 0.05）。两组治疗后TG、TC、LDL-C、YKL-40及hs-CRP水平均显著降低，HDL-C水平升高（P < 0.05）。治疗后治疗组HDL-C水平高于对照组，YKL-40及hs-CRP水平低于对照组（均P < 0.05）。
在西药抗炎及调脂基础上，GFD可进一步降低ACS患者血清YKL-40及hs-CRP水平，升高HDL-C水平，发挥抗动脉粥样硬化作用。
