Correlation Between Serum Lp-PLA2,Hp Infection And TCM Syndrome Types In Patients With Carotid Atherosclerosis

Objective:By comparing the differences and correlations of serum lipoprotein-associated phospholipase A2(Lp-PLA2)levels,Helicobacter pylori(Hp)infection,and related indicators among different TCM syndrome types in patients with carotid atherosclerosis(CAS),explore Guiding new ideas of AS TCM clinical syndrome differentiation combined with modern clinical tests and new types of indicators to provide objective and quantitative clinical evidence for TCM syndrome differentiation and treatment,exploring the effects of Lp-PLA2 and Hp on CAS formation and plaque morphology,and further improving the early prevention and treatment of AS Individualized treatment of TCM seeks objective evidence and new ideas.Method:Using the epidemiological survey method,150 CAS patients admitted to Nanjing University of Chinese Medicine were selected.According to the "Guiding Principles for Clinical Research of New Chinese Medicine(2002)" edited by Zheng Xiaozheng,and the "Effectiveness Standards for the Diagnosis of Cardiovascular Diseases in Traditional Chinese Medicine" edited by Shen Shaogong With the "Medicine Standards","Traditional Chinese Medicine Diagnostics" edited by Li Candong),"Internal Medicine of Traditional Chinese Medicine" edited by Zhou Zhongying and the clinical experience of the mentor,based on the primary and secondary syndromes,formulate sputum and blood stasis,qi stagnation and blood stasis,liver and kidney Yin deficiency,spleen-kidney yang deficiency were divided into four groups according to the diagnostic criteria.Another 30 healthy persons were collected as a control group.A questionnaire was developed to collect the general information of the patients,the four diagnosis information,the physical and chemical examination results,and the ultrasound imaging results.SPSS25 was used.The.0 statistical software analyzes the data,explores the relationship between the distribution of TCM syndrome types and biochemical indicators in CAS patients,and explores the specific indicators of the etiology and pathogenesis of TCM and clinical syndrome types in AS.Result:1.Compared with the control group,patients with CAS had differences in age and smoking(P<0.05).There was no significant difference in gender and body mass index(BMI).2.The Hp positive rate of CAS patients was different from the control group,and the serum Lp-PLA2 level was different from the control group,P<0.05.3.The distribution pattern of TCM syndromes in CAS patients is as follows:Qi stagnation and blood stasis group(65)>Phlegm and blood stasis group(48)>Spleen and kidney yang deficiency group(25)>Liver and kidney yin deficiency group(12).The comparison of basic data between the four groups found that there were differences in age(P<0.05),and no significant difference in gender and body mass index(P>0.05).4.The Hp antibody positive distribution was different among different TCM syndrome types(P<0.05),and the order was as follows:Qi stagnation and blood stasis>sputum and stasis stasis>Liver and kidney yin deficiency>Spleen and kidney yang deficiency,Qi stagnation and blood stasis group Hp antibody The positive rate was higher than that of spleen and kidney yang deficiency group.5.In the comparison of blood lipid levels among different TCM syndrome types,the levels of TC,TG,apolipoprotein A,and apolipoprotein B were not significantly different among the four groups of syndrome types,while LDL-C,HDL-C,and lipoprotein a were in the four groups.There were significant differences between the syndrome types in the group(P>0.05).The serum LDL-C level was significantly higher in the patients with phlegm and blood stasis than in the liver-kidney yin deficiency and spleen-kidney yang deficiency groups.The patients with liver-kidney yin deficiency had high serum lipoprotein a levels.In Qi stagnation and blood stasis and phlegm and blood stasis.6.Compared with different TCM syndrome types and pro-inflammatory factors,serum Lp-PLA2 was different between the four groups(P<0.05).Lp-PLA2 in Qi stagnation and blood stasis group was higher than other groups.There were also differences in hs-CRP among the four groups of syndrome types(P<0.05).The level of hs-CRP in Qi stagnation and blood stasis group was higher than that of spleen and kidney yang deficiency and phlegm and blood stasis.7.In the comparison of blood coagulation-related indicators in different TCM syndrome types,it was found that PT,FIB,and D-Dimer levels were compared and found that there was no significant difference between the four groups of syndrome types(P>0.05).There was a difference between the four groups of syndrome types(P<0.05).FIB levels in the patients with phlegm-stasis syndrome were significantly higher than those in the spleen-kidney yang deficiency group.8.There were differences in serum Hcy levels among patients with different TCM syndrome types(P<0.05).Hcy levels in the spleen and kidney yang deficiency group and qi stagnation and blood stasis group were significantly higher than those in the phlegm and blood stasis group.9.Different TCM syndrome types have significant differences in plaque formation(P<0.01).Qi stagnation and blood stasis group is more likely to form plaques than spleen and kidney yang deficiency group.There were also differences in the distribution of unstable plaques(P<0.05).10.Hp infection,Lp-PLA2 and CAS were positively correlated,r(Hp)=0.614,r(LP-PLA2)=0.547,P<0.05,and Hp and Lp-PLA2 were positively correlated(r=0.524,P=0.05).11.Hp infection,LP-PLA2,hs-CRP were positively correlated with unstable plaque formation r(Hp)=0.558,r(LP-PLA2)=0.634,r(hs-CRP)=0.301,P<0.05.12.The area under the ROC curve predicted by Lp-PLA2 for unstable plaque was 0.82(P<0.05),hs-CRP was 0.73(P<0.05,statistically significant),and LDL-C was 0.481(P>0.05).),Lp-PLA2,hs-CRP area is significantly larger than LDL-C,the optimal critical value for predicting the formation of unstable plaques Lp-PLA2=284.69ng/ml,hs-CRP is 9.55mg/L,Lp-PLA2,hs-CRP has higher specificity and sensitivity for predicting plaque instability.13.CAS was used as the dependent variable(No=0,Yes=1),and the relevant factor of CAS was independent variable multivariate binary logistic regression.The results showed that H.pylori infection can be used as CAS in the same way as hypertension and hyperlipidemia.The formation of independent risk factors(P<0.05).conclusion:1.Hp infection is an independent risk factor for CAS.Hp infection is significantly associated with Lp-PLA2,hs-CRP,and may be related to Hp infection causing related inflammatory factors to increase AS.2.Hp infection,Lp-PLA2,hs-CRP are closely related to the formation of unstable plaques.Changes in the levels of Lp-PLA2,hs-CRP are highly specific and sensitive for predicting the formation of unstable plaques or plaque rupture.Sex.3.Qi stagnation and blood stasis syndrome patients are more prone to Hp infection,and Lp-PLA2,hs-CRP are closely related to qi stagnation and blood stasis syndrome,elevated LDL-C levels are closely related to phlegm and blood stasis syndrome,and elevated FIB levels are associated with Phlegm and blood stasis are closely related to each other,an increase in lipoprotein a level is closely related to liver and kidney yin deficiency,and an increase in Hcy level is closely related to spleen and kidney yang deficiency.4.The characteristics of the effects of Hp infection on AS are in line with the theory of "Evil" in traditional Chinese medicine.Evil Eurasian is concealed,producing evil poisons,and is evoked internally and externally.Traditional Chinese medicine treatment for AS cannot blindly promote blood circulation and remove blood stasis.