982例心脑合病患者发病特点分析

The Onset Characteristics of 982 Cases of Angina Pectoris Complicated With Atherosclerotic Thrombotic Cerebral Infarction

目的探讨心脑合病(冠心病心绞痛合并动脉粥样硬化性血栓性脑梗死)患者的发病特点。方法收集2009年5月至2010年7月11家三级医院(辽宁地区为主)的心脑合病患者982例,对其性别、年龄、民族、工作性质、教育程度、发病节气、发病部位顺序、既往史、常见证型等进行统计分析。结果 982例患者中男性525例,女性457例;平均年龄(67.92±9.86)岁,其中60～75岁患者比例最高,共481例占48.98%;汉族964例占98.17%,少数民族17例占1.73%;工作性质以离退休人员最多,共407例占41.45%;教育程度以初中程度最多,共328例占33.40%;发病节气排在前10位的为小雪、小寒、霜降、寒露、春分、立冬、惊蛰、大寒、白露、立春,共598例占60.92%;心脑合病多由心病发展而来;既往史以高血压病史为多,共724例占73.73%;常见证型为痰瘀互结证、气虚血瘀证、风痰阻络证、气阴两虚证、风痰阻络兼气阴两虚证,共441例占44.91%。结论心脑合病患者发病年龄大、合并症多、证候复杂,且多在冬季和冬春交替、秋冬交替时节发病。

Objective To research the onset characteristics of angina pectoris （AP） complicated with atherosclerotic thrombotic cerebral infarction （ATCI）. Methods Totally 982 cases of AP complicated with ATCI. were collected from May 2009 to July 2010 mainly in Liaoning Province. The gender, age, ethnicity, nature of work, education, onset solar terms, diseased parts order, past medical history and common patterns were analyzed. Results There were 525 male patients and 457 female patients aged from 36 to 84 with an average of （67.92 ± 9.86） years old and 481 patients （48.98%） aged from 60 to 75. There were 964 cases （98.17%） of Han nationality and 17 cases of ethnic minority （ 1.73% ）. There were 407 （41.45%） retirees and 328 cases （33.40%） with junior secondary education level. Onset was more common in winter, early spring or late autumn. The top 10 onset solar terms were Light Snow, Minor Cold, Frost Descent, Cold Dew, Vernal Equinox, Start of Winter, Awakening of Insects, Major Cold, White Dew and Start of Spring accounting for 60. 92% （598 cases）. The primary disease in most patients was heart disease and 724 cases （73.73%） with hypertension history. The common patterns were phlegm-stasis binding together pattern, qi deficiency blood stasis pattern, wind-phlegm obstructing the network vessels pattern, qi-yin deficiency pattern and wind-phlegm obstructing the network vessels combined with qi-yin deficiency pattern accounting for 44. 91% （441 cases）. Conclusion Most of AP complicated with ATCI patients are old and poor ability to adapt with more complications and complex patterns and should be paid more attention to prevention and treatment.