高血压病中医证型与B型脑钠肽及脑卒中风险的相关性初探

Correlation of traditional Chinese medicine syndromes with B-type natriuretic peptide and the risk of stroke in patients with essential hypertension:a preliminary study

目的:探讨原发性高血压(EH)患者中医证型与B型脑钠肽(BNP)及未来10年脑卒中风险的相关性。方法:采用开放性临床研究,通过对EH患者中医辨证分型、BNP的测定及对未来10年脑卒中发生率的评估,探讨中医证型与BNP及脑卒中风险的相关性。结果:①血清BNP水平与未来10年脑卒中风险显著相关,EH患者BNP水平上升1pg/mL,脑卒中发生率升高0.50%;②EH患者各证型间血清BNP水平:痰湿壅盛组(1.46±0.49)>阴阳两虚组(1.31±0.56)>阴虚阳亢组(1.27±0.49)>肝火亢盛组(1.24±0.43);③EH患者各证型间未来10年脑卒中发生率:痰湿壅盛组(13.29%±10.54%)>阴阳两虚组(10.71%±6.06%)>肝火亢盛组(10.34%±6.80%)>阴虚阳亢组(9.90%±10.35%)。结论:EH患者血清BNP水平与中医证型相关,痰湿壅盛证型BNP水平较高;EH患者血清BNP水平与未来10年脑卒中风险相关;EH患者中医证型对脑卒中发生率可能有一定的预测作用,痰湿壅盛证型的EH未来10年脑卒中风险较高。

Objective： To study on the correlation of serum level of BNP with the risk of stroke in 10 years coming and TCM syndromes in patients with essential hypertension.Methods： Use open clinical research,through the differentiation of symptoms and signs for classification of syndrome of TCM,detect serum BNP and evaluate the risk of stoke in 10 years,to study on the correlation of TCM syndromes with serum BNP and the risk of stroke.Results： ①The serum level of BNP correlated with the risk of stroke in 10 years in the future.Fitting the regression equation between BNP and the rate of Stroke： when BNP ascended 1pg/mL,the risk of stroke set up 0.50%.②The serum level of BNP： stagnation of phlegm-dampness type（1.46±0.49） yin-yang deficiency type（1.31±0.56） hyperactivity of yang due to yin deficiency type（1.27±0.49） liver-fire excess type（1.24±0.43）.③The risk of stroke in 10 years：stagnation of phlegm-dampness type（13.29% ± 10.54%） yin-yang deficiency type（10.71% ± 6.06%） liver-fire excess type（10.34%±6.80%） hyperactivity of yang due to yin deficiency type（9.90%±10.35%）.Conclusion： The serum level of BNP correlated with TCM syndromes and stagnation of phlegm-dampness type was significant higher in patients with essential hypertension.The serum level of BNP correlated with the risk of stroke in 10 years;TCM syndromes might calculate the risk of stroke in 10 years and it was highest in the phlegm-dampness type in patients with essential hypertension.