不同ApoE基因型急性冠脉综合征患者中医证素特征与GRACE评分相关性研究

Correlation between Traditional Chinese Medicine Syndrome Elements and GRACE Risk Score in ACS Patients with Different ApoE Genotypes

目的 观察不同ApoE基因型急性冠状动脉综合征(ACS)患者中医证素特征和GRACE评分之间的关系,为ACS患者个体化诊疗提供新思路。方法 收集249例ACS患者的中医证素信息、ApoE基因型、GRACE评分等资料,分析不同ApoE基因型ACS患者中医证素特征与GRACE评分的相关性。结果 共纳入ApoE2基因型32例,ApoE3基因型175例,ApoE4基因型42例。其中具有统计学差异的结果(P<0.05):E4组寒凝证与GRACE-年龄评分相关系数r=0.325 0,气虚证与GRACE-年龄评分相关系数r=0.329 0,气虚证评分与GRACE-总分相关系数r=0.388 2,痰浊证和GRACE-Killip分级评分相关系数r=0.386 0;E3组寒凝证与GRACE-肌酐评分相关系数r=0.442 0,寒凝证评分与GRACE-危险因素评分相关系数r=0.888 5,痰浊证与GRACE-危险因素评分相关系数r=0.149 2,热蕴证评分与GRACE-收缩压评分相关系数r=0.601 9。结论 E4基因型寒凝证、气虚证、痰浊证的ACS患者GRACE评分危险程度更高;E3基因型寒凝证、痰浊证、热蕴证的ACS患者GRACE评分危险程度更高。

Objective:To observe the relationship between traditional Chinese medicine syndrome elements and GRACE risk score in patients with different ApoE genotypes in acute coronary syndrome(ACS),and to provide new ideas for individualized diagnosis and treatment of ACS patients.Methods:Information on TCM syndrome,ApoE genotype,physical and imaging examination results,and GRACE risk score were collected from 249 ACS patients to analyze the correlation between TCM syndrome features of different ApoE genotypes in ACS patients and GRACE risk score.Results:A total of 32 cases of ApoE2 genotype,175 cases of ApoE3 genotype,and 42 cases of ApoE4 genotype were included.The results were statistically different(P<0.05):the correlation coefficient between coagulated cold syndrome score and GRACE-age score in the E4 group was r=0.3250,the correlation coefficient between qi deficiency syndrome score and GRACE-age score was r=0.3290,the correlation coefficient between qi deficiency syndrome score and GRACE-total score was r=0.3882,and the correlation coefficient between turbid phlegm syndrome score and GRACE-Killip grade score was r=0.3860.In the E3 group,the correlation coefficient between coagulated cold syndrome score and GRACE-creatinine score was r=0.4420,the correlation coefficient between coagulated cold syndrome score and GRACE-risk factor score was r=0.8885,the correlation coefficient between turbid phlegm syndrome score and GRACE-risk factor score was r=0.1492,and the correlation coefficient between heat accumulation syndrome score and GRACE-systolic blood pressure score was r=0.6019.Conclusion:The risk level of GRACE score in ACS patients with E4 genotype of coagulated cold syndrome,qi deficiency syndrome,and turbid phlegm syndrome is higher.ACS patients with E3 genotype of coagulated cold syndrome,turbid phlegm syndrome,and heat accumulation syndrome have a higher risk of GRACE score.