结合眼底血管特征研究2种中医证型缺血性中风患者的2年期复发风险  

Combining Oculus Fundus Vascular Characteristics to Study the Risk of Two-Year Recurrence in Patients with Ischemic Stroke of Two Traditional Chinese Medical Syndromes

作　　者：卓缘圆[1] 于海波[1] 黄杏贤[1] 洪金标[1] 黄奕珊[1] 李作为[2] 吴家满[3] ZHUO Yuan-yuan;YU Hai-bo;HUANG Xing-xian;HONG Jin-biao;HUANG Yi-shan;LI Zuo-wei;WU Jia-man(Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518028, China;School of Public Health, The Chinese University of Hong Kong, Hong Kong, 999077, China;Traditional Chinese Medicine Department, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518033, China)

机构地区：[1]深圳市中医院针灸科,广东深圳518028 [2]香港中文大学公共卫生学院,香港999077 [3]深圳市妇幼保健院中医科,广东深圳518033

出　　处：《南京中医药大学学报》2021年第6期853-859,共7页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金(81803952);国家重点研发计划(2019YFC1712200);国际针灸临床研究服务标准研制课题(2019YFC171205);深圳市医疗卫生“三名工程”(SZSM201612001)。

摘　　要：目的构建结合眼底血管特征的不同中医证型的缺血性中风复发风险评估模型。方法采用前瞻性观察研究,共纳入425例符合纳入标准的缺血性中风患者并随访2 a,采集与中风相关的临床风险因素、中医证型及眼底血管特征参数信息,采用生存分析法比较气虚血瘀证和风痰阻络证缺血性中风患者的复发风险,运用单因素分析辨识中风复发的核心危险因素和眼底血管特征,分别建立2个证型的多因素Logistic复发风险评估模型。结果2个证型的复发风险比较,风痰阻络证较气虚血瘀证高(P<0.05)。气虚血瘀证缺血性中风复发风险评估模型受试者ROC曲线下面积值为0.7996,风痰阻络证缺血性中风复发风险评估模型值为0.7193。结论风痰阻络证缺血性中风患者复发风险较气虚血瘀证高,建立识别不同证型缺血性中风复发的风险因素模型可以为临床提供有针对性的预防策略。OBJECTIVE To establish a model for risk assessment of recurrent ischemic stroke by combining different traditional Chinese medicine(TCM)syndromes with oculus fundus vascular characteristics.METHODS In a prospective observational study,a total of 425 ischemic stroke patients who met the inclusion criteria were enrolled and followed up for two years.In addition,the information on clinical risk factors,TCM syndromes,and oculus fundus vascular characteristics related to stroke were collected.Survival analysis was used to compare the risk of recurrence in patients with ischemic stroke with qi deficiency and blood stasis and wind-phlegm obstructing collaterals.A multifactorial Logistic risk assessment model was developed for each of the two evidence types using single-factor analysis to identify the core risk factors for stroke recurrence and oculus fundus vascular characteristics.RESULTS Through comparing the recurrence risk between the two syndromes,we found that the recurrence risk was higher in the wind-phlegm obstructing collaterals syndrome than that in the qi deficiency and blood stasis syndrome(P<0.05).The area under curve value of the ischemic stroke risk assessment model of qi deficiency and blood stasis syndrome was 0.7996,while the value of the ischemic stroke risk assessment model of wind-phlegm obstructing collaterals syndrome was 0.7193.CONCLUSION The risk of recurrence in patients with ischemic stroke of wind-phlegm obstructing collaterals syndrome is higher than that of qi deficiency and blood stasis syndrome,and the establishment of a risk factor model to identify recurrence in different syndromes of ischemic stroke can provide targeted prevention strategies for clinical practice.

关 键 词：缺血性中风 气虚血瘀证 风痰阻络证 眼底血管特征 风险评估 复发 

分 类 号：R255.2[医药卫生—中医内科学]