435例原发性高血压患者脉图参数与心血管危险分层的相关性分析  

Correlation Between Pulse Graph Parameters and Cardiovascular Risk Stratification in 435 Patients with Essential Hypertension

作　　者：解天骁 赵倩倩 杨晶东[2] 张梦楚 李媛媛 徐璡 郭睿[1] 王忆勤[1] 燕海霞[1] Xie Tianxiao;Zhao Qianqian;Yang Jingdong;Zhang Mengchu;Li Yuanyuan;Xu Jin;Guo Rui;Wang Yiqin;Yan Haixia(Shanghai Key Laboratory of Health Identification and Assessment,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;School of Optoelectronic Information and Computer Engineering,Shanghai University of Technology,Shanghai 200093,China)

机构地区：[1]上海中医药大学上海市健康辨识与评估重点实验室,上海201203 [2]上海理工大学光电信息与计算机工程学院,上海200093

出　　处：《世界科学技术-中医药现代化》2022年第6期2443-2449,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会面上项目(81973749):基于中医脉象检测的原发性高血压患者不同心血管危险分层预警模型的构建与验证,负责人:燕海霞;国家自然科学基金委员会面上项目(81473594):基于血液动力学原理和方法的中医脉象分析与血管功能状态评价研究,负责人:燕海霞。

摘　　要：目的本研究旨在探讨原发性高血压患者脉图参数与心血管危险分层的相关性,为原发性高血压患者心血管风险事件预警提供中医特色的依据。方法采集435例原发性高血压患者的症状体征、脉象信息、生化指标等,分为低中危组、高危组、很高危组,采用单因素方差分析、秩和检验、有序logistic回归分析等方法,探讨原发性高血压患者脉图参数与心血管危险分层的相关性。结果(1)高血压低中危组→高危组→很高危组患者病程逐渐延长,两两组间比较有统计学差异;(2)高血压低中危组→高危组→很高危组患者的脉图参数H3/H1、H4/H1逐渐上升;高血压患者很高危组H5/H1、T1/T低于低中危组;(3)有序logistic回归分析结果显示,脉图参数T1、T4、T5、T为影响因素。结论病程、血脂、肾功能是高血压患者心血管危险分层的影响因素之一。心血管危险分层等级的升高与脉图参数H3/H1、H4/H1、T5、T的升高及H5/H1、T4、T1的降低相关,说明脉图能一定程度上反映原发性高血压患者血管壁增厚、血管内壁受损、血管硬化及左心室收缩功能的减退程度。Objective To explore the correlation between pulse map parameters and cardiovascular risk stratification inpatients with essential hypertension,and to provide the basis of traditional Chinese medicine for the early warning ofcardiovascular risk events in patients with essential hypertension.Methods The symptoms,signs,pulse information andbiochemical indexes of 435 patients with essential hypertension were collected and divided into low and medium risk group,high risk group and very high risk group.The correlation between pulse parameters and cardiovascular riskstratification in patients with essential hypertension was discussed by means of one-way ANOVA,rank sum test,orderedlogistic regression analysis and machine learning.Results(1)The course of hypertension in low and medium risk group→high risk group→very high risk group was gradually prolonged,and there was significant difference between the twogroups.(2)The pulse parameters H3/H1 and H4/H1 of patients in low and medium risk group→high risk group→veryhigh risk group increased gradually;H5/H1 and T1/T in high-risk group were lower than those in low and medium riskgroup.(3)Ordered logistic regression analysis showed that pulse map parameters T1,T4,T5 and T were the influencingfactors of cardiovascular risk stratification of hypertension.Conclusion The course of disease,blood lipid index andrenal function are one of the influencing factors of cardiovascular risk stratification in patients with hypertension.Theincrease of cardiovascular risk stratification level is related to the increase of pulse map parameters H3/H1,H4/H1,T5and T and the decrease of H5/H1,T4 and T1,indicating that pulse map can reflect the degree of vascular wallthickening,vascular wall damage,vascular sclerosis and left ventricular systolic function in patients with essentialhypertension to a certain extent.

关 键 词：原发性高血压 危险分层 有序Logistic回归分析 机器学习 

分 类 号：R2-03[医药卫生—中医学]