脑血管疾病患者动脉狭窄程度及其与危险因素、中医体质的相关性研究

Study on the Degree of Arterial Stenosis in Patients with Cerebrovascular Disease and its Correlation with Risk Factors and TCM Constitution

目的研究脑血管疾病患者动脉狭窄程度及分布情况与危险因素、中医体质的相关性。方法选择2020年10月-2022年10月安徽中医药大学附属太和中医院收治的258例基于DSA证实的脑血管狭窄患者,采用现场调查方式收集患者的中医体质类型,并对其危险因素及血管狭窄情况进行统计分析。结果纳入患者中以颈动脉狭窄比例较高(49.22%),其次为椎动脉狭窄(36.43%)和大脑中动脉狭窄(36.05%)。Spearman相关性分析显示,颈动脉狭窄与痰湿质、血瘀质、气郁质呈正相关;椎动脉狭窄与气虚质、血瘀质呈正相关;大脑中动脉狭窄与血瘀质呈正相关;基底动脉狭窄与痰湿质、血瘀质呈正相关(P<0.05);另外,高血压与阴虚质呈正相关;糖尿病与阴虚质、气虚质、痰湿质、湿热质呈正相关;高血脂与气虚质、血瘀质呈正相关;高HCY与气虚质、血瘀质呈正相关(P<0.05)。二分类多因素Logistic回归分析显示,年龄、吸烟、饮酒、高血压、糖尿病、高血脂为颅内外动脉狭窄的危险因素,即年龄越大、吸烟、饮酒者动脉狭窄的可能性高于年轻者、非吸烟者和非饮酒者,高血压、糖尿病、高血脂患者相比非疾病患者动脉狭窄的可能性更高;中医体质中的痰湿质、血瘀质患者动脉狭窄可能性更高。结论脑血管疾病患者动脉狭窄程度情况与危险因素、中医体质有一定的相关性。

Objective To study the correlation between the degree and distribution of arterial stenosis in patients with cerebrovascular disease and risk factors and TCM constitution.Methods A total of 258 patients with cerebrovascular stenosis confirmed by DSA admitted to Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese Medicine from October 2020 to October 2022 were selected.The TCM constitution types of the patients were collected by field investigation,and the risk factors and vascular stenosis were statistically analyzed.Results Among the included patients,the proportion of carotid stenosis was higher(49.22%),followed by vertebral artery stenosis(36.43%)and middle cerebral artery stenosis(36.05%).Spearman correlation analysis showed that carotid artery stenosis was positively correlated with phlegm dampness,blood stasis and qi stagnation;vertebral artery stenosis was positively correlated with qi deficiency,and blood stasis;middle cerebral artery stenosis was positively correlated with blood stasis;basilar artery stenosis was positively correlated with phlegm dampness and blood stasis;hypertension was positively correlated with yin deficiency;diabetes was positively correlated with yin deficiency,qi deficiency,phlegm dampness and damp heat;hyperlipidemia is positively correlated with qi deficiency and blood stasis;high HCY was positively correlated with qi deficiency and blood stasis(P<0.05).Logistic regression analysis showed that age,smoking,drinking,hypertension,diabetes and hyperlipidemia were risk factors for intracranial and extracranial arterial stenosis.The older,smoking and drinking were more likely to have arterial stenosis than those of the younger,non-smokers and non-drinkers.Patients with hypertension,diabetes and hyperlipidemia were more likely to have arterial stenosis than those of non-disease patients.Patients with phlegm dampness and blood stasis in TCM constitution were more likely to have arterial stenosis.Conclusion The degree of arterial stenosis in patients with cerebrovascular disease is related to risk factors and TCM constitution.