高血压患者中医证型与冠状动脉病变相关性研究

Relativity Study on Hypertension Vertigo Syndromes and Coronary Artery Disease

[目的]分析高血压患者冠状动脉病变与中医证型的相关性,高血压中医证型辨析在评价冠状动脉病变中的价值及患者冠状动脉检查的意义。[方法]回顾性分析经冠状动脉CT血管成像(CTCA)检查的高血压患者209例,采用64层螺旋CT检查,分析冠状动脉病变特点,并对比证型诊断,分析其相关性。[结果]高血压分级、血脂升高与高血压中医证型无明显的相关性(P>0.05)。高血压中医证型与冠状动脉粥样硬化斑块性质构成比,差异有统计学意义(P<0.05)。各中医证型与斑块狭窄程度两两比较差异有统计学意义(P<0.01),肝火亢盛证与痰湿壅盛证在斑块狭窄程度上比较差异有统计学意义(P<0.01),在这两证型中冠脉狭窄轻度与中度(P=0.004)、重度(P=0.005)比较差异有统计学意义(P<0.01)。[结论]高血压患者冠状动脉狭窄程度、斑块构成比与中医证型存在一定的相关性,准确的证型诊断可以帮助我们重视高血压患者冠状动脉可能存在的病变。

[Purpose] Analyse the correlation of coronary artery disease in patients of hypertension with TCM syndromes.Evaluate the value of coronary artery disease in hypertension with syndromes and the significance of coronary angiography in patients with hypertension.[Methods] Retrospective analysis of 209 cases of hypertension under coronary CT angiography（CTCA）.Using 64-slioe spiral CT,we analysed the characteristics of coronary artery disease and compared the diagnostic syndromes,analyzed its relevance.[Results] There was no significant correlation between classification of hypertension,elevated blood lipids,the degree of coronary stenosis and hypertension.Hypertension and the composition ratio of coronary atherosclerotic plaque and the degree of stenosis had some correlation,but no significant correlation with coronary atherosclerotic plaque（N=169,P〉0.05）.There was no statistical difference between classification of hypertension or elevated blood lipids and hypertension.There was statistical difference between hypertension and the composition ratio of coronary atherosclerotic plaque（P〈0.05）.Hypertension pairwise compared with the degree of coronary stenosis,the discrepance was significant.Comparing the degree of coronary stenosis of cardphlegmatic of anger hyperactivity and hypertension,the discrepance was statistically significant（P〈0.01）,the degrees of coronary stenosis compared with each other in both syndromes,mild with moderate（P=0.004）,and with severe（P=0.005） had statistically significant differences.[Conclusion]The hypertension was significantly correlated with the degree of coronary stenosis and the composition ratio of coronary atherosclerotic plaque.Accurate syndromes can help us pay attention on coronary lesions that may be present in patients.