冠心病稳定期患者发生心血管事件的证候相关预测因素研究
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国家重点研发计划“中医药现代化研究”重点专项(2019YFC1708501);国家重点基础研究发展(“973计划”)计划项目(2014CB542903);佛山市科技创新项目(中医药领域先行先试科技攻关专项)(2020001005585)


Syndrome-related Predictors of Cardiovascular Events in Patients with Stable Coronary Heart Disease
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    摘要:

    目的:探讨冠心病稳定期患者发生心血管事件的证候相关预测因素。方法:回顾性分析课题组于2016年10月至2018年4月收集的冠心病稳定期患者的临床资料,共纳入2 856例患者,其中96例患者于第1次访视后6个月内发生心血管事件,为观察组,其余2 760例未发生心血管事件的患者为对照组。收集患者一般信息、饮食习惯、症状信息与中医证等资料,采用单因素分析和多因素logistic回归统计分析其证候相关预测因素。结果:本研究显示,冠心病稳定期患者6个月内发生心血管事件的发生率为3.36%。单因素方差分析显示,性别、婚姻状况、饮食习惯是否规律、偏嗜辛辣、肌肤甲错、四肢末端紫绀、脉涩、入睡困难、头晕、头重如裹、两颧发红、眼周青紫或黯黑、烦躁易怒、异常舌苔、沉脉、阴虚证、郁热证等17个因素是冠心病稳定期患者发生心血管事件的预测因素(P<0.05);多因素Logistic回归分析显示,男性(OR=1.64,95%CI为1.03~2.62,P=0.04)、异常舌苔(OR=1.91,95%CI为1.12~3.25,P=0.02)、烦躁易怒(OR=1.88,95%CI为1.22~2.88,P<0.01)、沉脉(OR=2.41,95%CI为1.5~3.96,P<0.01)、两颧发红(OR=2.46,95%CI为1.49~3.91,P<0.01)是冠心病稳定期患者发生心血管事件的预测因素,而偏嗜辛辣是冠心病稳定期患者发生心血管事件的保护因素(OR=0.33,95%CI为0.13~0.85,P=0.02)。结论:除了西医常见预测因素外,证候相关因素对提示冠心病稳定期患者发生心血管事件也具有一定价值,应给予更多重视并加以深入研究。

    Abstract:

    To investigate the syndrome-related predictors of cardiovascular events in the patients with stable coronary heart disease.Methods:A retrospective study was conducted on the clinical data of the patients with stable coronary heart disease from October 2016 to April 2018.A total of 2 856 patients were enrolled in this study,including 96 patients who had cardiovascular events within 6 months after the first visit(observation group) and 2 760 patients who had no cardiovascular events(control group).The data of general information,dietary habits,symptoms,and TCM syndrome of the patients were collected.Single factor analysis and multivariate logistic regression were employed to explore the syndrome-related predictors.Results:The incidence of cardiovascular events within 6 months in the patients with stable coronary heart disease was 3.36%.The results of single factor analysis showed that sex,marital status,regularity of dietary habits,preference for spicy food,dry scaly skin,cyanosis at the end of limbs,astringent pulse,difficulty in falling asleep,dizziness,heaviness of head,red cheeks,dark eye circles,irritability,abnormal tongue coating,deep pulse,syndrome of yin deficiency,and syndrome of heat stagnation were the predictors of cardiovascular events in the patients with stable coronary heart disease(P<0.05).The results of multivariate logistic regression showed that male patients(OR=1.64,95%CI 1.03 to 2.62,P=0.04),abnormal tongue coating(OR=1.91,95%CI 1.12 to 3.25,P=0.02),irritability(OR=1.88,95%CI 1.22 to 2.88,P<0.01),deep pulse(OR=2.41,95%CI 1.5 to 3.96,P<0.01),and red cheeks(OR=2.46,95%CI 1.49 to 3.91,P<0.01) were predictors and preference for spicy food(OR=0.33,95%CI 0.13 to 0.85,P=0.02) was the protective factor for cardiovascular events in the patients with stable coronary heart disease.Conclusion:In addition to the common predictors in western medicine,syndrome-related factors also demonstrate the potential of predicting cardiovascular events in the patients with stable coronary heart disease,which deserves attention and remains to be studied.

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陈南杰,王传池,佟旭,杨燕,吴朦,汪锦城,吴珊,周聪慧,江丽杰,许伟明,胡镜清.冠心病稳定期患者发生心血管事件的证候相关预测因素研究[J].世界中医药,2023,(10).

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  • 收稿日期:2022-11-09
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  • 在线发布日期: 2023-06-06
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