非瓣膜性心房颤动与脑卒中高危人群颈动脉硬化的相关性分析及中医证候要素分布研究

Observation on the Correlation between Non-valvular Atrial Fibrillation and Carotid Atherosclerosis for High Risk Group of Stroke and Its TCM Syndrome

目的:探讨房颤与脑卒中高危人群颈动脉硬化发生的相关性及中医证候要素分布规律。方法:选取脑卒中高危人群5999例,分为房颤组和非房颤组进行对比,观察2组人群颈动脉内膜中层厚度及斑块形成情况,观察2组中医证候要素分布规律。结果:房颤组在吸烟、血脂异常方面较无房颤组检出率高,差异有统计学意义(P<0.05);房颤患者颈动脉内膜增厚及颈动脉斑块形成发生率较无房颤患者高;多因素Logistic回归分析显示,颈动脉内膜增厚与房颤、高血压病、吸烟、饮食习惯、脑卒中家族史、缺乏体育锻炼等相关;中医证候要素各组之间差异无统计学意义(P<0.05)。结论:吸烟和血脂异常是房颤患者发生脑卒中的独立危险因素;房颤组更易出现颈动脉内膜增厚及斑块形成。房颤组痰湿证、内风证较多出现,但房颤与否并不影响中医证候要素类型及分布。

Objective： To observe the correlation between non-valvular atrial fibrillation and carotid atherosclerosis for high risk group of stroke and its TCM Syndrome distribution. Methods： A total of 5999 patients of high risk group of stroke were divided into atrial fibrillation group and non-atrial fibrillation group. Carotid artery ultrasound was applied to observe the intima mediathickness（ IMT） and atherosclerotic plaque. To observe the distribution of TCM syndrome elements in the two groups. Results： The detection rate of smoking and dyslipidemia in atrial fibrillation group was higher than non-atrial fibrillation group,and the difference was statistically significant（ P〈0. 05）. Compared with non-atrial fibrillation group,the occurrence rates of IMT and atherosclerotic plaque in atrial fibrillation group were significantly higher（ P〈0. 05）. Logistic multi-factor regression analysis showed that atrial fibrillation,hypertension,smoking,eating habits,family history of stroke,lack of physical exercise were associated with IMT of carotid artery. There was no significant difference in TCM syndrome elements between the two groups（ P〉0. 05）. Conclusion： In the high risk group of stroke,smoking and dyslipidemia are independent risk factor for carotid atherosclerosis and plaque formation. Carotid artery intima and plaque formation in the atrial fibrillation group was higher. The major syndrome elements of atrial fibrillation group are phlegm dampness and wind. While atrial fibrillation has no effects on the types and distribution of TCM syndrome elements.