气虚血瘀型冠心病心绞痛与心脏结构及心功能指标相关性分析

Correlation Analysis Between Angina Pectoris in Coronary Heart Disease of Qi Deficiency and Blood Stasis Type and Cardiac Structure and Cardiac Function Index

目的:探讨气虚血瘀型冠心病心绞痛与心脏结构及心功能指标的相关性。方法:选取2017年6月—2019年6月沈丘县中医院和郑州大学第一附属医院收治的冠心病心绞痛患者142例作为疾病组,另从同期到医院体检的健康人群中选取100例为健康组。疾病组患者根据中医辨证分为气虚血瘀组(气虚血瘀型冠心病心绞痛)和非气虚血瘀组(非气虚血瘀组冠心病心绞痛)。对比疾病组与健康组、气虚血瘀与非气虚血瘀组的心脏结构及心功能指标。单因素分析可能影响气虚血瘀型冠心病心绞痛的发生因素,Logistic回归分析证实气虚血瘀型冠心病心绞痛的危险因素。结果:与健康组比较,疾病组的左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室后壁厚度(LVPWd)、室间隔厚度(IVST)更大(P<0.05),左室射血分数(LVEF)、左心室短轴速率(LVFS)、每搏量(SV)更小(P<0.05)。与非气虚血瘀组比较,气虚血瘀组的LVDd、LVDs更大(P<0.05),LVEF、LVFS更小(P<0.05)。与非气虚血瘀组比较,气虚血瘀组的血清总胆固醇(TC)≥5.99 mmol/L、LVDd≥55 mm、LVDs≥37 mm、LVEF<60%、LVFS<30%的占比更高(P<0.05);Logistic回归分析证实以上均是气虚血瘀型冠心病心绞痛的危险因素。结论:TC≥5.99 mmol/L、LVDd≥55 mm、LVDs≥37 mm、LVEF<60%、LVFS<30%是影响气虚血瘀型冠心病心绞痛的危险因素,可将以上指标作为气虚血瘀型冠心病心绞痛的辨证依据。

Objective:To discuss the correlation between angina pectoris in coronary heart disease of qi deficiency and blood stasis type and cardiac structure and cardiac function index.Methods:A total of 142 cases of patients with angina pectoris in coronary heart disease treated in Shenqiu Hospital of Chinese Medicine and First Affiliated Hospital of Zhengzhou University from June 2017 to June 2019 were selected as the disease group,and 100 healthy people who came to the hospitals for physical examination at the same time were selected as the healthy group.According to Chinese medicine syndrome differentiation,the disease group was divided into the qi deficiency and blood stasis group(angina pectoris in coronary heart disease of qi deficiency and blood stasis type)and the non qi deficiency and blood stasis group(angina pectoris in coronary heart disease not of qi deficiency and blood stasis type).The cardiac structures and cardiac function indexes between the disease group and the healthy group as well as between the qi deficiency and blood stasis group and the non qi deficiency and blood stasis group were compared.Univariate analysis may affect the risk factors of angina pectoris in coronary heart disease of qi deficiency and blood stasis type,and logistic regression analysis confirmed its risk factors.Results:Compared with those in the healthy group,the left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),left ventricular posterior wall thickness(LVPWd)and interventricular septal thickness(IVST)in the disease group were more(P<0.05),and left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS)and stroke volume(SV)were less(P<0.05).Compared with those in the non qi deficiency and blood stasis group,LVDd and LVDs in the qi deficiency and blood stasis group were more(P<0.05),and LVEF and LVFS were less(P<0.05).Compared with those in the non qi deficiency and blood stasis group,the proportions of total cholesterol(TC)≥5.99 mmol/L,LVDd≥55 mm,LVDs≥37 mm,LVEF<60%and LVFS<30%in serum in the qi deficiency and blood stasis group were higher(P<0.05);logistic regression analysis showed that the above syndromes were risk factors of angina pectoris in coronary heart disease of qi deficiency and blood stasis type.Conclusion:TC≥5.99 mmol/L,LVDd≥55 mm,LVDs≥37 mm,LVEF<60%and LVFS<30%are risk factors of angina pectoris in coronary heart disease of qi deficiency and blood stasis type.The above indexes can be used as the basis of syndrome differentiation of angina pectoris in coronary heart disease of qi deficiency and blood stasis type.