高血压合并颈动脉硬化中医证型与血清FIB、Cys-C及血脂水平的关系

Relationship between Traditional Chinese Medicine Syndromes and Serum FIB,Cys-C,Blood Lipid Levels for Patients with Hypertension and Carotid Atherosclerosis

目的:探讨高血压合并颈动脉硬化中医证型与血清纤维蛋白原(FIB)、胱抑素C(Cys-c)及血脂水平的关系。方法:回顾性分析2018年6月~2021年6月在本院诊治的458例高血压合并颈动脉硬化患者,统计患者的性别、年龄、病程、中医证候、血清FIB、血清Cys-c及血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]等临床资料,分析中医证型与其它指标的关系。结果:458例高血压合并颈动脉硬化患者中,中医证型以脾虚湿阻证(27.17%)为主,其次为气虚痰瘀证(26.42%)和气滞血瘀证(20.52%)。不同中医证型的年龄、病程、血清FIB、血清Cys-c及血脂水平,差异比较具有统计学意义(P<0.05);且脾虚湿阻证、气虚痰瘀证、肝肾阴虚证年龄较高,肝肾阴虚证、脾虚湿阻证患者的平均病程较长,气虚痰瘀证、痰瘀虚阻证患者的TC水平较高,痰瘀虚阻证、气滞血瘀证、肝阳上亢证患者的TG水平较高,气虚痰瘀证、气滞血瘀证、肝肾阴虚证患者的LDL-C水平较高,痰瘀虚阻证患者的FIB、Cys-c水平较高,组间差异均有统计学意义(P<0.05)。结论:高血压合并颈动脉硬化不同中医证型患者的血清FIB、Cys-c及血脂水平均有差异,临床诊治可根据中医证候预估血清指标的大概趋势,指导实验检测指标。

Objective:To explore the relationship between TCM syndromes and serum fibrinogen(FIB),cystatin-C(Cys-c),blood lipid levels in hypertension combined with carotid atherosclerosis.Methods:A retrospective analysis was performed on the 458 patients with hypertension and carotid atherosclerosis treated in the hospital between June 2018 and June 2021.The clinical data of patients were statistically analyzed,including gender,age,course of disease,TCM syndromes,levels of serum FIB,Cys-c and blood lipid indexes[total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)].The relationship between TCM syndromes and the other indexes was analyzed.Results:Among the 458 patients with hypertension and carotid atherosclerosis,the main TCM syndrome was spleen-deficiency dampness obstruction(27.17%),followed by Qi-deficiency phlegm stasis(26.42%)and Qi-stagnation blood stasis(20.52%).The differences in age,course of disease,levels of serum FIB,Cys-c and blood lipid among patients with different TCM syndromes were statistically significant(P<0.05).The age was relatively older in patients with spleen-deficiency dampness obstruction,Qi-deficiency phlegm stasis,and liver-kidney Yin deficiency.The average disease course was relatively longer in patients with liver-kidney Yin deficiency,and spleen-deficiency dampness obstruction.TC level was relatively higher in patients with Qi-deficiency phlegm stasis,and phlegm-stasis deficiency obstruction.TG level was relatively higher in patients with phlegm-stasis deficiency obstruction,Qi-stagnation blood stasis,and liver-Yang hyperaction.LDL-C level was relatively higher in patients with Qi-deficiency phlegm stasis,Qi-stagnation blood stasis,and liver-kidney Yin deficiency.The levels of FIB and Cys-c were relatively higher in patients with phlegm-stasis deficiency obstruction,the differences in different groups were statistically significant(P<0.05).Conclusion:The levels of serum FIB,Cys-c and blood lipid are different in patients with hypertension and carotid atherosclerosis of different TCM syndromes.In clinical diagnosis and treatment,TCM syndromes can be applied predict the approximate trends of serum indexes and guide experimental test indexes.