大鱼际表征与冠心病相关性研究

Research on Relevance of Thenar Eminence Representation and Coronary Heart Disease

目的探索大鱼际异常表征与冠心病的相关性,为冠心病大鱼际望诊法提供相关临床研究依据。方法纳入486例经冠状动脉血管CT造影(CTA)检查患者,根据检查结果将患者分为冠状动脉(冠脉)无狭窄组(n=132例)、冠脉非梗阻性狭窄组、冠心病组。采用单因素Logistic回归分析、随机森林等数据挖掘方法,综合大鱼际表征、基本信息、既往病史、一级亲属家族心血管病史等多种指标,提取与冠脉非梗阻性狭窄、冠心病人群相关的大鱼际异常表征,并分析冠心病组大鱼际异常表征与冠脉病变支数关系。结果多分类Logistic回归结果显示:以无狭窄作为考虑,有大鱼际皱褶的患者出现冠脉非梗阻性狭窄几率增加[OR=1.714,95%CI(1.02,2.881),P<0.05];有大鱼际色红的患者出现冠心病几率增加[OR=1.884,95%CI(1.089,3.258),P<0.05],有大拇指根部青筋的患者出现冠心病几率增加[OR=1.885,95%CI(1.045,3.291),P<0.05];以非梗阻性狭窄作为考虑,有大拇指根部青筋的患者出现冠心病几率增加[OR=1.884,95%CI(1.024,3.321),P<0.05]。大拇指根部青筋与冠脉多支病变相关[OR=2.583,95%CI(1.106,6.576),P<0.05]。结论大鱼际皱褶是冠脉非梗阻性狭窄的独立相关因素;大鱼际色红、大拇指根部青筋等异常表征是冠心病独立的相关因素。该研究补充了冠心病中医望诊内容,为冠心病患者的临床诊察提供了新的思路。

Objective To explore the relevance between thenar characterization and coronary heart disease,which provides clinical reference for the inspection of thenar characterization of coronary heart disease. Methods 486 patients were included and divided into normal group(n=196 cases),nonobstructive coronary stenosis group(n=132 cases),coronary heart disease(CHD)group(n=158 cases)according to coronary CTA results. Adopted univariate logistic regression,random forest data and other statistics and data mining methods to analyze thenar characterization,basic information,personal life history,past medical history,family history of cardiovascular history of first-degree relatives and determine abnormal thenar characterization in non-obstructive stenosis group and CHD group. Analyzed the relationship between abnormal thenar characterization and number of coronary lesion vessels in CHD group. Results Logistic regression analysis results of multiple factors showed that the incidence of non-obstructive stenosis increased for patients with"thenar fold"[OR=1.714,95%CI(1.02,2.881),P<0.05] compared to no stenosis;The risk of coronary heart disease increased for the patients with"red thenar"[OR=1.884,95%CI(1.089,3.258),P<0.05] compared to no stenosis;The risk of coronary heart disease increased for the patients with"green tendon of thumb root"[OR=1.885,95%CI(1.045,3.291),P<0.05];The risk of coronary heart disease increased for the patients with"green tendon of thumb root"[OR=1.884,95%CI(1.024,3.321),P<0.05] compared to non-obstructive stenosis. Green tendon of thumb root are related to coronary multi-vessel lesions [OR=2.583,95%CI(1.106,6.576),P<0.05]. Conclusion The thenar fold is an independent relevant factor of non-obstructive coronary stenosis. The red thenar and green tendon of thumb root are independent relevant factors of coronary heart disease. This study complements the contents of TCM inspection diagnosis of CHD and provides a new clinical inspection method for patients with CHD.