摘要
目的:总结进展性脑梗死(PCI)的高危因素,分析中医证型与其相关性,并探讨各高危因素对不同中医证型患者病情进展的影响。方法:选取急性脑梗死(ACI)住院患者680例,根据入院后病情演变分为进展组(PCI组)和非进展组(NPCI组)。观察项目包括性别、年龄、烟酒嗜好、高血压病史、糖尿病病史、血压收缩压与舒张压、美国国立卫生研究院卒中量表(NIHSS)评分、血小板计数、白细胞(WBC)计数、纤维蛋白原(FIB)、胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、快速空腹血糖(FPG)、糖化血红蛋白(HbAlc)、同型半胱氨酸(HCY)、脂蛋白-a(LP-a)、血尿酸(UA)、总胆红素(TBil)及颈动脉狭窄等,并对指标进行相关统计分析。结果:经单因素分析,高血压史、颈动脉狭窄、年龄、TG、FPG、LP-a、HbAlc在PCI组与NPCI组比较差异有统计学意义(P<0.05),对这些因素继而行Logistic回归分析,发现TG、FPG增高、HbAlc、颈动脉狭窄、年龄为PCI的独立高危因素。并且,风火上扰证患者的FPG水平、风痰阻络证与痰热腑实证患者的TG水平、气虚血瘀证患者的年龄与HbAlc水平、风痰阻络证及气虚血瘀证患者的颈动脉狭窄情况在PCI组与NPCI组间的差异具有统计学意义(P<0.05)。另外气虚血瘀证在PCI组与NPCI组证型分布上与其他证型比较差异有统计学意义(P<0.05)。结论:TG偏高、FPG增高、HbAlc增高、颈动脉狭窄、年龄偏大为PCI发病的独立危险因素。且这些高危因素对不同证型的进展影响不同,尤以气虚血瘀证患者较其他证型患者发生脑梗死后更易进展。
Objective:To Summarize high risk factors for progressive cerebral infarction(PCI),analyze the correlation between the factors and traditional Chinese medicine(TCM)syndrome of PCI,and explore the effects of each high risk factor imposing on patients with different TCM syndrome.Methods:A total of 680 patients with acute cerebral infarction were included and divided into two progressive cerebral infarction(PCI)group and non-progressive cerebral infarction(NPCI)group.The observation items included:gender,age,tobacco and alcohol addiction,history of hypertension and diabetes mellitus,systolic pressure,diastolic pressure,NIHSS scores,blood platelet counts,white blood count,fibrinogen,cholesterol,triglyceride(TG),high density lipoprotein cholesterol,low density lipoprotein,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1C),homocysteine,lipoprotein-a(LP-a),blood uric acid,total bilirubin,carotid artery stenosis.These items were analyzed statistically.Results:According to univariate analysis,the differences of the history of hypertension,carotid artery stenosis,age,TG,FPG,LP-a and HbA1C between the two groups were statistically significant.Then logistic regression analysis was utilized to analyze the above items and the results suggested that TG,FBG,HbA1C,carotid artery stenosis and age were independent high risk factors for PCI.Besides,the FPG level in patients with wind-fire disturbance syndrome,the TG level in patients with wind phlegm obstructing the channels syndrome or phlegm-heat and bowel-repletion syndrome,the HbA1C level and age in patients with qi-deficiency and blood-stasis syndrome,and carotid artery stenosis in patients with wind phlegm obstructing the channels syndrome or qi-deficiency and blood-stasis syndrome of the two groups were statistically different.Among TCM syndromes,the distribution of qi-deficiency and blood-stasis syndrome in the two groups was different from others.Conclusions:Higher TG,FBG and HbA1C,carotid artery stenosis and higher age are independent high risk factors for PCI.These high risk factors have different impact on different TCM syndrome.Patients with qi-deficiency and blood-stasis syndrome easily generate progression of cerebral infarction.
作者
马岱朝
陈文博
陈亮
唐勇
潘平康
彭先波
曹娇
张超
王晓玲
MA Daichao;CHEN Wenbo;CHEN Liang;TANG Yong;PAN Pingkang;PENG Xianbo;CAO Jiao;ZHANG Chao;WANG Xiaoling(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)
出处
《山东中医杂志》
2020年第8期814-819,831,共7页
Shandong Journal of Traditional Chinese Medicine
基金
陕西省卫生计生委科研基金项目(编号:2016D079)。
关键词
进展性脑梗死
独立高危因素
中医证型
疾病进展
甘油三脂
空腹血糖
糖化血红蛋白
颈动脉狭窄
年龄因素
progressive cerebral infarction
independent high risk factors
traditional Chinese medicine syndrome
disease progression
triglyceride
fasting plasma glucose
glycosylated hemoglobin
carotid artery stenosis
age
