【摘要】：目的:初步探討冠狀動(dòng)脈粥樣硬化性心臟病(以下簡稱“冠心病”)患者肱踝脈搏波傳導(dǎo)速度(ba PWV)和頸動(dòng)脈內(nèi)中膜厚度(IMT)的相關(guān)性,及患者中醫(yī)體質(zhì)分布情況。材料與方法:選擇2015年5月-2017年1月遼寧中醫(yī)藥大學(xué)附屬醫(yī)院心內(nèi)一科收治的117例冠心病患者為研究對象,平均年齡58.79±9.39(40-80)歲,其中男44例,女73例,采用日本VS-1000動(dòng)脈硬化診斷儀進(jìn)行檢測,根據(jù)ba PWV檢測結(jié)果,分為對照組(ba PWV1400cm/s)56例,觀察組(ba PWV≥1400 cm/s)61例,記錄患者的詳細(xì)病史,采集患者的身高、體重、血脂等信息,計(jì)算體重指數(shù),測踝臂指數(shù)、頸動(dòng)脈IMT,并對入選患者的中醫(yī)體質(zhì)進(jìn)行問卷調(diào)查。所有數(shù)據(jù)用SPSS17.0統(tǒng)計(jì)分析軟件進(jìn)行處理、分析,假設(shè)檢驗(yàn)統(tǒng)一使用雙側(cè)檢驗(yàn),以P0.05作為有統(tǒng)計(jì)學(xué)意義,以P0.01作為有顯著性統(tǒng)計(jì)學(xué)意義。結(jié)果:1.兩組患者危險(xiǎn)因素的比較:在年齡、BMI、TG、CHOL、LDL-C和頸動(dòng)脈IMT值這六項(xiàng)有明顯差異,P0.05,差異有統(tǒng)計(jì)學(xué)意義。2.兩組患者危險(xiǎn)因素相關(guān)性的比較:年齡、BMI、TG、CHOL、LDL-C和IMT與ba PWV呈顯著正相關(guān),P0.05,差異有統(tǒng)計(jì)學(xué)意義。相關(guān)系數(shù)r:1rIMTrTGrBMIrCHOLr年齡r LDL-C0。3.建立、分析兩組患者危險(xiǎn)因素的回歸模型:經(jīng)逐步回歸,最終進(jìn)入模型的兩個(gè)因素為TG和頸動(dòng)脈IMT,P0.01,有顯著統(tǒng)計(jì)學(xué)意義。logit(P)=-9.885+1.314×TG+0.687×IMT(χ2=24.483,P=0.000)4.經(jīng)Fisher的精確檢驗(yàn),得出兩組患者的中醫(yī)體質(zhì)分布狀態(tài):冠心病患者ba PWV不同,中醫(yī)體質(zhì)分布不同,差異有統(tǒng)計(jì)學(xué)意義(χ2=16.051,P=0.019)。具體如下:對照組的患者體質(zhì)為:氣虛質(zhì)痰濕質(zhì)=血瘀質(zhì)氣郁質(zhì)=濕熱質(zhì)陽虛質(zhì)=平和質(zhì)陰虛質(zhì)特稟質(zhì);觀察組患者為:痰濕質(zhì)血瘀質(zhì)氣虛質(zhì)=氣郁質(zhì)濕熱質(zhì)陽虛質(zhì)陰虛質(zhì)平和質(zhì)特稟質(zhì)。結(jié)論:1.ba PWV與頸動(dòng)脈IMT顯著正相關(guān),頸動(dòng)脈內(nèi)膜增厚的冠心病患者,其IMT每增厚0.1mm可能導(dǎo)致ba PWV加快的危險(xiǎn)性增加1.988倍。2.ba PWV加快的冠心病患者以痰濕質(zhì)為主要中醫(yī)體質(zhì),其次為血瘀質(zhì)、氣虛質(zhì)、氣郁質(zhì)。3.通過易感體質(zhì)識別潛在的冠心病患者,有助于早期發(fā)現(xiàn)冠心病亞臨床狀態(tài)人群,并通過改善患者體質(zhì)防治動(dòng)脈粥樣硬化。
[Abstract]:Objective: to investigate the correlation between brachial and malleolus pulse wave conduction velocity (ba PWV) and carotid intima-media thickness (IMT) in patients with coronary atherosclerotic heart disease (CAD), and the distribution of TCM physique in patients with coronary atherosclerotic heart disease (CAD). Materials and methods: 117 patients with coronary heart disease treated in the Department of Cardiology, affiliated Hospital of Liaoning University of traditional Chinese Medicine from May 2015 to January 2017 were selected as subjects with an average age of 58.79 鹵9.39 (40 鈮，

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