冠心病西北燥证与血瘀证罹患差异及与主要不良心血管事件相关性分析  

Study on the Prevalence Difference between Northwest Dryness Syndrome and Blood Stasis Syndrome of Coronary Heart Disease and the Correlation with Major Adverse Cardiovascular Events

作　　者：李欣彤 李鹏[2] 付长庚[3] 龙霖梓 周靖雅 胡嘉伟 赵宇太 LI Xintong;LI Peng;FU Changgeng;LONG Linzi;ZHOU Jingya;HU Jiawei;ZHAOYutai(The fourth Clinical Medical College of Xinjiang Medical University,Urumqi,830000;The Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University;Xiyuan Hospital of China Academy of Chinese Medical Sciences)

机构地区：[1]新疆医科大学第四临床医学院,新疆维吾尔自治区乌鲁木齐市830000 [2]新疆医科大学附属中医医院 [3]中国中医科学院西苑医院

出　　处：《中医杂志》2024年第12期1255-1261,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82260917);新疆维吾尔自治区科技支疆项目计划(指令性)项目(2022E02114);新疆维吾尔自治区自然科学基金(2022D01D49)

摘　　要：目的探讨冠心病西北燥证与血瘀证罹患差异及其与发生主要不良心血管事件(MACE)的关系。方法纳入2015年11月1日至2020年9月30日在新疆医科大学附属中医医院心内科住院的499例冠心病患者,收集患者一般资料及心血管疾病危险因素(性别、年龄、吸烟史、糖尿病史、高血压病史、慢性肾病史、体质指数)、实验室指标(空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血肌酐、血尿素氮),进行西北燥证与血瘀证判断,并对一年内发生MACE情况随访,分析不同证型冠心病患者心血管危险因素的差异及与发生MACE的相关性。结果499例冠心病患者中单纯血瘀证128例(25.65%),单纯西北燥证33例(6.61%),西北燥证兼血瘀证209例(41.88%),非西北燥证非血瘀证129例(25.85%)。单因素回归分析显示,吸烟史、糖尿病史、空腹血糖异常、甘油三酯异常、高密度脂蛋白胆固醇异常均与冠心病患者罹患西北燥证呈正相关(OR>1且P<0.05),吸烟史、甘油三酯异常、高密度脂蛋白胆固醇异常均与冠心病患者罹患血瘀证呈正相关(OR>1且P<0.05);多因素回归分析显示,糖尿病史、甘油三酯异常、高密度脂蛋白胆固醇异常与冠心病西北燥证呈正相关(P<0.05),吸烟史、甘油三酯异常及高密度脂蛋白胆固醇异常与冠心病血瘀证呈正相关(P<0.05);关联规则分析显示,冠心病西北燥证患者合并血瘀证的置信度为86.36%,冠心病血瘀证患者合并西北燥证的置信度为62.02%。499例患者中一年内发生MACE患者96例(19.24%);Logistics回归分析显示:三种不同证型均与MACE发生存在相关性,相关性由强到弱依次为冠心病西北燥证兼血瘀证[OR=5.113,95%CI(3.118,8.387),P<0.001]、冠心病单纯血瘀证[OR=4.630,95%CI(2.394,8.955),P<0.001]、冠心病单纯西北燥证[OR=4.395,95%CI(2.642,7.309),P<0.001]。结论血瘀证是新疆维吾尔自治区冠心病患者的主�Objective To explore the prevalence difference between northwest dryness syndrome and blood stasis syndrome of coronary heart disease(CAD)and their correlations with major adverse cardiovascular events(MACE).Methods The medical records including general information and risk factors for vascular diseases(gender,age,smoking history,diabetes history,hypertension history,chronic kidney disease history and body mass index),laboratory indicators(fasting blood glucose,triglyceride,high density lipoprotein cholesterol,etc.)of 499 CAD patients in the Department of Cardiology of the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from November 1st,2015 to September 30th,2020 were collected,and whether they suffered from northwest dryness syndrome or blood stasis syndrome was judged.The incidence of MACE was followed up for one year.The differences of cardiovascular risk factors between the northwest dryness syndrome and blood stasis syndrome of CAD were compared,and the correlation with MACE was analyzed.Results Among the 499 CAD patients,there were 128 cases(25.65%)of simple blood stasis syndrome,33 cases(6.61%)of simple northwest dryness syndrome,209 cases(41.88%)of northwest dryness syndrome plus blood stasis syndrome,and 129(25.85%)cases of not blood statis syndrom either northwest dryness syndrome.Univariate regression analysis showed that smoking history,diabetes history,fasting blood glucose abnormality,triglyceride abnormality,and high density lipoprotein cholesterol abnormality were positively correlated with northwest dryness syndrome in CAD patients(OR>1,P<0.05),while smoking history,abnormal triglyceride and abnormal high density lipoprotein cholesterol were positively correlated with blood stasis syndrome in CAD patients(OR>1,P<0.05).Multivariate regression analysis showed that the history of diabetes,abnormal triglyceride and abnormal high density lipoprotein cholesterol were positively correlated with northwest dryness syndrome of CAD(P<0.05).Smoking history,abnormal trigly

关 键 词：冠心病 血瘀证 西北燥证 主要不良心血管事件 危险因素 队列研究 

分 类 号：R259[医药卫生—中西医结合]