221例不同中医证型后循环缺血患者眩晕影响因素研究

Influencing factors of vertigo in 221 patients with different TCM syndrome of posterior circulation ischemia

目的:调查后循环缺血性眩晕证型分布情况,分析影响因素的相关性。方法:纳入后循环缺血性眩晕患者221例,进行辨证分型,记录人口学资料、实验室指标及危险因素,并分析其相关性。结果:221例后循环缺血患者证型依次为:痰浊中阻证97例43.89%(97/221)、瘀血阻窍证52例23.53%(52/221)、肝肾阴虚证33例14.93%(33/221)、肝阳上亢证27例12.22%(27/221)、气血亏虚证12例5.43%(12/221);判别分析显示,身体质量指数(Body Mass Index,BMI)、血同型半胱氨酸(Homocysteine,HCY)、D-二聚体(D-Dmier)、三酰甘油(Triglyceride,TG)、高密度脂蛋白胆固醇(High-Density Lipoprotein Cholesterol,HDL-C)、右侧椎动脉管径、左侧椎动脉血流速度与辨证分型的诊断判别具有相关性(P <0.05)。二分类Logistic回归分析显示,D-Dmier与痰浊中阻证、瘀血阻窍证呈正相关(P <0.05);右侧椎动脉管径与瘀血阻窍证、肝肾阴虚证呈负相关(P <0.05);TG与肝肾阴虚证呈正相关(P <0.05)。结论:痰浊中阻证是临床常见证型,D-二聚体与脑血管事件的影响因素关系较为密切。

Objective: To investigate the distribution of syndrome types of posterior circulation ischemic vertigo and analyze the correlation of influencing factors. Methods: 221 patients with posterior circulation ischemic vertigo were enrolled in this study, and were classified according to syndrome differentiation. Demographic data, laboratory indicators and risk factors were recorded and their correlation was analyzed. Results: Among 221 patients, there were 97 cases of phlegm turbidity obstruction syndrome 43.89%(97/221), there were 52 cases of blood stasis obstruction syndrome 23.53%(52/221), there were 33 cases of liver and kidney yin deficiency syndrome 14.93%(33/221), there were 27 cases of liver yang hyperactivity syndrome 12.22%(27/221) and 12 cases of Qi and blood deficiency syndrome5.43%(12/221). Discriminant analysis showed that body mass index(BMI), blood homocysteine(HCY), D-dimer(D-Dmier), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), right vertebral artery diameter(mm), left vertebral artery blood flow velocity(cm/s) were correlated with the diagnosis and discrimination of syndrome differentiation(P<0.05). Logistic regression analysis showed that D-Dmier was positively correlated with phlegm turbidity obstruction syndrome and blood stasis obstruction syndrome(P<0.05);right vertebral artery diameter was negatively correlated with blood stasis obstruction syndrome and liver-kidney Yin deficiency syndrome(P<0.05);and TG was positively correlated with liver-kidney Yin deficiency syndrome(P<0.05). Conclusion: Phlegm turbidity obstruction syndrome is a common clinical syndrome. D-dimer is closely related to the influencing factors of cardiovascular events.