穩(wěn)定型心絞痛患者中慢性失眠與心臟舒張功能不全的相關(guān)性分析
發(fā)布時(shí)間：2019-01-01 20:52
【摘要】：目的:探討穩(wěn)定型心絞痛患者中,慢性失眠與心臟舒張功能不全的相關(guān)性及其可能的機(jī)制,歸納入組患者中醫(yī)證型分布,比較不同證型間心臟舒張功能的差異。以期為臨床診斷和治療心臟舒張功能不全提供思路。方法:在穩(wěn)定型心絞痛患者中,隨機(jī)選取符合慢性失眠診斷標(biāo)準(zhǔn)的患者183名,按失眠的病程分為4組,第一組6個(gè)月-2年,第二組2年-5年,第三組5年-10年,第四組10年。對(duì)比4組患者一般情況,高敏C-反應(yīng)蛋白(hs-CRP),心臟彩超參數(shù)及舒張功能等級(jí),HRV(心率變異性)中的SDNN,夜間平均心率的差異性;分析失眠年限與E/E,相關(guān)性,與HRV中SDNN相關(guān)性,與夜間平均心率的相關(guān)性,與高敏C反應(yīng)蛋白的相關(guān)性;基于中醫(yī)辨證,分析心臟舒張功能患者與中醫(yī)證型之間的關(guān)系;分析慢性失眠患者中醫(yī)證型之間的關(guān)系。結(jié)果:1、Pearson相關(guān)性分析發(fā)現(xiàn)失眠年限與E/E'正相(r=0.712,P0.01),與SDNN呈負(fù)相關(guān)(r=-0.516,P0.01),與夜間平均心率呈正相關(guān)(r=0.742,P0.01),與 hs-CRP 正相關(guān)(r=0.715,P0.01)。2、控制變量年齡、性別、高血壓、糖尿病、高脂血癥,偏相關(guān)分析發(fā)現(xiàn)現(xiàn)失眠年限與E/E'正相關(guān)(r=0.710,P0.01),與SDNN呈負(fù)相關(guān)(r=-0.509,P0.01),與夜間平均心率正相關(guān)(r=0.739,P0.01),與 hs-CRP正相關(guān)(r=0.717,P0.01)。3、Spearman分析失眠年限組別與心臟舒張功能等級(jí)之間的相關(guān)性,發(fā)現(xiàn)失眠年限分組與心臟舒張功能等級(jí)之間的呈正相關(guān)(r=0.659,P0.05)。4、入組患者的中醫(yī)證型的分布比例不同,從高到低,依次為痰阻心脈證、氣陰兩虛證、心血瘀阻證、氣滯血瘀證、氣虛血虛證、陰寒凝滯證、陽(yáng)氣虛衰證、心腎陰虛證。組間比較痰阻心脈證與氣滯血瘀證、氣虛血虛證、氣陰兩虛證、心血瘀阻證之間存在統(tǒng)計(jì)學(xué)差異(P0.05),心血瘀阻證與陰寒凝滯證、陽(yáng)氣虛衰證、痰阻心脈證之間存在統(tǒng)計(jì)學(xué)差異(P0.05),氣虛血虛證與氣滯血瘀之間存在統(tǒng)計(jì)學(xué)差異(P0.05),其他證型之間無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論:1、在本研究中,慢性失眠與心臟舒張功能不全存在相關(guān)性,失眠年限越長(zhǎng),心臟舒張功能越低;2、在本研究中,失眠年限與SDNN呈負(fù)相關(guān)、與夜間平均心率呈正相關(guān)、與hr-CRP呈正相關(guān);3、本研究的穩(wěn)定型心絞痛患者中,慢性失眠的發(fā)生可能存在證型分布的差異,其中痰阻心脈型的患者發(fā)生率更高。
[Abstract]:Objective: to investigate the relationship between chronic insomnia and cardiac diastolic dysfunction in patients with stable angina pectoris and its possible mechanism, and to summarize the distribution of TCM syndromes in patients with stable angina pectoris, and to compare the difference of cardiac diastolic function among different syndromes. In order to provide ideas for clinical diagnosis and treatment of cardiac diastolic dysfunction. Methods: one hundred and thirty-three patients with stable angina pectoris were randomly divided into 4 groups according to the course of insomnia: the first group was 6 months to 2 years, the second group was 2 to 5 years, and the third group was 5 to 10 years. The fourth group is 10 years old. The differences of SDNN, mean heart rate in Gao Min C-reactive protein (hs-CRP), cardiac color Doppler ultrasound parameters and diastolic grade, HRV (heart rate variability were compared among the four groups. To analyze the correlation between insomnia years and E / E, SDNN in HRV, average heart rate at night and Gao Min C-reactive protein, to analyze the relationship between cardiac diastolic function patients and TCM syndrome type based on TCM syndrome differentiation. To analyze the relationship between TCM syndrome types of chronic insomnia patients. Results: 1Insomnia was negatively correlated with E / E 'positive phase (r = 0.712), SDNN was negatively correlated with SDNN (r ~ (-0.516) P _ (0.01), and was positively correlated with mean heart rate at night (r _ (0. 742) P _ (0.01). (2) Age, sex, hypertension, diabetes, hyperlipidemia, partial correlation analysis showed that the number of years of insomnia was positively correlated with E / E'(r = 0.710 / P0.01). There was a negative correlation with SDNN (r-0.509, P 0.01), a positive correlation with the mean heart rate at night (r = 0.739, P 0.01), and a positive correlation with hs-CRP (r = 0.717, P 0.01). Spearman analysis showed that there was a positive correlation between sleep duration group and cardiac diastolic function grade (r = 0.659P 0.05), and the correlation between sleep duration group and cardiac diastolic function grade was positive (r = 0.659P 0.05). The distribution of TCM syndromes of the patients in the group was different, from high to low, followed by phlegm blocking heart pulse syndrome, qi and yin deficiency syndrome, heart blood stasis syndrome, qi stagnation and blood stasis syndrome, qi deficiency and blood deficiency syndrome, yin cold stagnation syndrome, yang qi deficiency failure syndrome, heart and kidney yin deficiency syndrome. There were statistical differences between the two groups in phlegm obstruction and blood stasis syndrome, qi deficiency and blood deficiency syndrome, qi and yin deficiency syndrome, heart blood stasis syndrome (P0.05), heart blood stasis syndrome and Yin cold stagnation syndrome, Yang Qi deficiency failure syndrome, There was statistical difference between phlegm blocking heart and pulse syndrome (P0.05), there was statistical difference between Qi deficiency and blood deficiency syndrome and qi stagnation and blood stasis (P0.05), but there was no statistical difference among other syndrome types. Conclusion: 1. In this study, chronic insomnia and cardiac diastolic dysfunction have a correlation, the longer the insomnia, the lower the cardiac diastolic function; 2. In this study, the years of insomnia were negatively correlated with SDNN, positively correlated with mean heart rate at night, and positively correlated with hr-CRP. 3. In the patients with stable angina pectoris in this study, the occurrence of chronic insomnia may be different in the distribution of syndromes, among which the incidence of phlegm blocking heart vein type is higher.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259
本文編號(hào)：2398094
[Abstract]:Objective: to investigate the relationship between chronic insomnia and cardiac diastolic dysfunction in patients with stable angina pectoris and its possible mechanism, and to summarize the distribution of TCM syndromes in patients with stable angina pectoris, and to compare the difference of cardiac diastolic function among different syndromes. In order to provide ideas for clinical diagnosis and treatment of cardiac diastolic dysfunction. Methods: one hundred and thirty-three patients with stable angina pectoris were randomly divided into 4 groups according to the course of insomnia: the first group was 6 months to 2 years, the second group was 2 to 5 years, and the third group was 5 to 10 years. The fourth group is 10 years old. The differences of SDNN, mean heart rate in Gao Min C-reactive protein (hs-CRP), cardiac color Doppler ultrasound parameters and diastolic grade, HRV (heart rate variability were compared among the four groups. To analyze the correlation between insomnia years and E / E, SDNN in HRV, average heart rate at night and Gao Min C-reactive protein, to analyze the relationship between cardiac diastolic function patients and TCM syndrome type based on TCM syndrome differentiation. To analyze the relationship between TCM syndrome types of chronic insomnia patients. Results: 1Insomnia was negatively correlated with E / E 'positive phase (r = 0.712), SDNN was negatively correlated with SDNN (r ~ (-0.516) P _ (0.01), and was positively correlated with mean heart rate at night (r _ (0. 742) P _ (0.01). (2) Age, sex, hypertension, diabetes, hyperlipidemia, partial correlation analysis showed that the number of years of insomnia was positively correlated with E / E'(r = 0.710 / P0.01). There was a negative correlation with SDNN (r-0.509, P 0.01), a positive correlation with the mean heart rate at night (r = 0.739, P 0.01), and a positive correlation with hs-CRP (r = 0.717, P 0.01). Spearman analysis showed that there was a positive correlation between sleep duration group and cardiac diastolic function grade (r = 0.659P 0.05), and the correlation between sleep duration group and cardiac diastolic function grade was positive (r = 0.659P 0.05). The distribution of TCM syndromes of the patients in the group was different, from high to low, followed by phlegm blocking heart pulse syndrome, qi and yin deficiency syndrome, heart blood stasis syndrome, qi stagnation and blood stasis syndrome, qi deficiency and blood deficiency syndrome, yin cold stagnation syndrome, yang qi deficiency failure syndrome, heart and kidney yin deficiency syndrome. There were statistical differences between the two groups in phlegm obstruction and blood stasis syndrome, qi deficiency and blood deficiency syndrome, qi and yin deficiency syndrome, heart blood stasis syndrome (P0.05), heart blood stasis syndrome and Yin cold stagnation syndrome, Yang Qi deficiency failure syndrome, There was statistical difference between phlegm blocking heart and pulse syndrome (P0.05), there was statistical difference between Qi deficiency and blood deficiency syndrome and qi stagnation and blood stasis (P0.05), but there was no statistical difference among other syndrome types. Conclusion: 1. In this study, chronic insomnia and cardiac diastolic dysfunction have a correlation, the longer the insomnia, the lower the cardiac diastolic function; 2. In this study, the years of insomnia were negatively correlated with SDNN, positively correlated with mean heart rate at night, and positively correlated with hr-CRP. 3. In the patients with stable angina pectoris in this study, the occurrence of chronic insomnia may be different in the distribution of syndromes, among which the incidence of phlegm blocking heart vein type is higher.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 陳淼;武星;王國(guó)興;;阿托伐他汀對(duì)糖尿病心肌病患者心臟舒張功能的影響[J];中國(guó)慢性病預(yù)防與控制;2017年01期
2 李志明;陳麗;周京敏;;脂聯(lián)素在心臟舒張功能不全中的研究進(jìn)展[J];中國(guó)臨床醫(yī)學(xué);2016年05期
3 李燕萍;郝應(yīng)祿;陳利華;楊嫻;陶此玲;王銳;繆英;;射血分?jǐn)?shù)保留的心力衰竭臨床特征[J];昆明醫(yī)科大學(xué)學(xué)報(bào);2016年04期
4 王曉寧;沃金善;郭潔;;芪藶強(qiáng)心膠囊輔助治療冠心病合并左心舒張功能不全的臨床效果[J];疑難病雜志;2016年02期
5 楊兵生;許逸飛;徐青云;陳潔;劉強(qiáng);毛威;;益心舒膠囊聯(lián)合比索洛爾對(duì)舒張性心衰大鼠的治療作用[J];中國(guó)現(xiàn)代應(yīng)用藥學(xué);2016年01期
6 宋碩彥;;螺內(nèi)酯聯(lián)合地爾硫卓對(duì)舒張性心衰心功能不全的改善作用[J];哈爾濱醫(yī)藥;2015年S1期
7 郝愛菊;;卡維地洛和尼可地爾治療冠心病心肌缺血并左室舒張功能不全患者的效果分析[J];中國(guó)醫(yī)藥指南;2015年35期
8 王友娟;李虹;薛一濤;;舒張性心力衰竭的發(fā)病機(jī)制及中醫(yī)中藥治療研究進(jìn)展[J];中西醫(yī)結(jié)合心腦血管病雜志;2015年12期
9 袁蓉;王階;郭麗麗;林飛;;失眠增加心血管病致病因子的研究[J];中國(guó)比較醫(yī)學(xué)雜志;2015年07期
10 羅蓮;汪漢;蔡琳;;左室舒張功能不全性心力衰竭的最新進(jìn)展[J];心血管病學(xué)進(jìn)展;2015年04期
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