摘要
目的探讨动脉弹性指标和血管内皮功能指数(FMD)与冠状动脉粥样硬化性心脏病(冠心病)“血瘀证”相关性及对“血瘀证”的预测价值。方法纳入2019年1月—2020年1月在中日友好医院因冠心病住院的患者201例,根据中医诊断分为血瘀证组114例和非血瘀证组87例,测量2组患者动脉弹性指标[臂踝动脉脉搏波速度(baPWV)、踝肱指数(ABI)]和FMD,采用Logistic回归模型和指标联合接受者操作特性曲线(ROC)评估动脉弹性及血管内皮功能指标对冠心病血瘀证的预测能力。结果血瘀证组患者的ABI及FMD均明显低于非血瘀证组(P均<0.05),baPWV明显快于非血瘀证组(P<0.05)。baPWV、ABI、FMD与冠心病血瘀证独立相关(P均<0.05),当患者baPWV≥18.22 m/s或ABI≤1.04或FMD≤8.2%时,可以诊断预测患者为冠心病血瘀证人群。baPWV、ABI、FMD联合评价时,ROC曲线下面积明显高于单一指标(AUC=0.80,P均<0.05),同金标准具有中等强度一致性。结论baPWV、ABI、FMD与冠心病血瘀证独立相关,且对其具有一定诊断预测意义,三者联合评判时预测价值更高。
Objective It is to investigate the correlation between arterial elasticity indexes and vascular endothelial function index(FMD value)and blood stasis syndrome of coronary heart disease,and to discuss its predictive value for blood stasis syndrome in clinical practice.Methods A total of 201 patients who were hospitalized with coronary heart disease in China-Japan Friendship Hospital from January 2019 to January 2020 were included.According to the diagnosis of traditional Chinese medicine,they were divided into a blood stasis syndrome group of 114 cases and a non-blood stasis syndrome group of 87 cases.The arterial elasticity indicators[brachial-ankle pulse wave velocity(baPWV),ankle-brachial index(ABI)]and FMD of the patients in the two groups was measured.Logistic regression model and indicators combined with receiver operating characteristic curve(ROC)were used to evaluate the predictive ability of arterial elasticity and vascular endothelial function indicators in coronary heart disease with blood stasis syndrome.Results The ABI and FMD of the blood stasis syndrome group were significantly lower than those of the non-blood stasis syndrome group(all P<0.05),and the baPWV was significantly faster than that of the non-blood stasis syndrome group(P<0.05).baPWV,ABI and FMD were independently correlated with blood stasis syndrome of coronary heart disease(all P<0.05).When baPWV≥18.22 m/s or ABI≤1.04 or FMD≤8.2%,the patients could be diagnosed and predicted to be coronary heart disease blood stasis syndrome population.In the joint evaluation of baPWV,ABI and FMD,the area under the ROC curve was significantly higher than that of a single index(AUC=0.80,all P<0.05),which had moderate consistency with the gold standard.Conclusion baPWV,ABI and FMD were independently associated with blood stasis syndrome in coronary heart disease and had some diagnostic predictive significance for the syndrome,and the predictive value was higher when the three indexes were evaluated jointly.
作者
王子涵
陈颖
吕书影
孙梓宜
姚睿祺
鹿小燕
黄力
WANG Zihan;CHEN Ying;LYU Shuying;SUN Ziyi;YAO Ruiqi;LU Xiaoyan;HUANG Li(Beijing University of Chinese Medicine, Beijing 100029, China;China-Japan Friendship Hospital, Beijing 100029, China)
出处
《现代中西医结合杂志》
CAS
2022年第6期748-752,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
国家重点研发计划项目(2017YFC1700100,2017YFC1700102)
首都卫生发展科研专项项目(2020-2-4064)。
关键词
冠状动脉粥样硬化性心脏病
血瘀证
动脉弹性
血管内皮功能
中医辨证
临床预测模型
coronary heart disease
blood stasis syndrome
arterial elasticity
vascular endothelial function
syndrome differentiation
clinical prediction models
