结合中医体质因素的缺血性脑血管病脑动脉狭窄危险因素分析

Analysis based on TCM body constitution theory on risk factors for cerebral artery stenosis in patients with ischemic cerebrovascular disease

目的 探讨缺血性脑血管病（Ischemic cerebrovascular disease,ICVD）患者脑动脉狭窄与中医体质的相关性。方法 根据中医体质判定标准调查297例ICVD患者的中医体质,并进行主动脉弓＋全脑血管造影。采用二元Logistic回归分析方法,以脑动脉有无狭窄作为因变量,自变量包括中医体质、年龄、BMI、性别、高血压病史、糖尿病病史、血脂异常史、吸烟史、酗酒史。结果 297例缺血性脑血管病患者,238例存在脑动脉狭窄病变,无狭窄病例59例。Logistic回归分析显示：痰湿质（OR=5.028,95%CI 1.924-13.145,P=0.001）、血瘀质（OR=7.689,95%CI 1.626-36.361,P=0.010）、年龄（OR=4.348,95%CI 1.990-9.498,P〈0.001）、高血压病史（OR=5.860,95%CI 1.210-28.323,P=0.028）、糖尿病史（OR=7.041,95%CI 2.916-17.002,P〈0.001）、血脂异常史（OR=3.295,95%CI 1.440-7.539,P=0.005）和吸烟史（OR=4.341,95%CI 1.829-10.299,P=0.001）是脑动脉狭窄的独立危险因素。结论 缺血性脑血管病患者中医体质与脑动脉狭窄相关。脑动脉狭窄的危险因素判断应结合中医体质分析。

Objective To study the correlation between cerebral arterial stenosis and TCM body constitution in patients with ischemic cerebrovascular disease（ICVD）. Methods We conducted a questionnaire survey among 297 patients with ICVD by using the standard of TCM body constitution theory. All the patients underwent aortic archand cerebral angiography. The method of binaryLogistic regression analysis was applied. For the cerebral arterial stenosis, binary variable was taken as dependent variable. The independent variables included TCM constitution, age, BMI, gender, hypertension, diabetes, dyslipidemia, smoking,drinking. Results Of the 297 patients,238 patients were with cerebral arterial stenosis,59 patients without stenosis. Logistic regression showed that phlegm-dampness constitution （ OR = 5. 028,95% CI 1. 924 - 13. 145 ,P =0. 001 ） ,blood stasis constitution（ OR =7. 689,95% CI 1. 626 -36. 361 ,P --0. 010） ,age（ OR =4. 348,95% CI 1. 990 -9. 498 ,P 〈0. 001 ） ,the histories of hypertension（ OR =5. 860,95% CI 1. 210 -28. 323 ,P =0. 028） ,diabetes （ OR = 7.041,95 % C1 2.916 - 17. 002, P 〈 0.001 ）, dyslipidemia （ OR = 3. 295,95 % CI 1. 440 - 7. 539, P = 0. 005 ） and smoking （ OR = 4. 341,95 % CI 1. 829 - 10. 299, P = 0. 001 ） were the independent risk factors for the cerebral artery stenosis. Conclusion TCM body constitution was associated with cerebral artery stenosis in patients with ICVD. The analysis of risk factors for the cerebral arterial stenosis should be combined with TCM body constitution theory.