【作者】 丛丛；

【导师】 杨传华；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2008， 硕士

【摘要】 目的:观察203例老年人高血压病中络病的分布特点及其与baPWV(脉搏波传导速度)的相关性,评价老年高血压络病与动脉僵硬度的关联度。方法:入选203例老年高血压病人,按照络病和血瘀证的诊断标准分为4组:2个单一病证组(络病组、血瘀证组)、1个复合病证组(络病+血瘀证组)和无病证组(非络病+非血瘀证组)。统一完成中医证候及有关病史资料的完整采集,采用日本colin全自动动脉硬化测定仪测定baPWV(脉搏波传导速度)。观察老年高血压病中络病的分布情况以及其与动脉僵硬度的相关性。结果:1.各组构成比不等,络病+血瘀证组的构成比(0.429)最高;非络病组和络病组组间比较,BMI、WHR(肥胖)、吸烟例数、舒张压、平均动脉压、危险分层的差异均无显著性(P>0.05);年龄、性别、收缩压、脉压的差异有显著性(P<0.05或<0.01);与非络病组相比,络病组的年龄、男性性别、收缩压、脉压和baPWV均较高(P<0.05或<0.01)。2.年龄、性别、收缩压、脉压、baPWV是老年络病的预测因子,而吸烟、BMI、舒张压、平均动脉压与络病的发生无关;年龄、脉压、baPWV(P<0.001)为三个独立预测老年高血压“络病”发生的危险因子,其中对络病影响最大的变量是baPWV(β=1.122)。结论:1.在老年高血压病中,络病及其与血瘀证相关的复合证型较为常见。2.老年高血压病络病与动脉僵硬度可能存在相关性,鉴于样本量相对不足,尚不能建立非条件Logistic回归模型,充分校正年龄、高收缩压和危险分层等对络病患者的影响。为此,扩大样本量,深入分析年龄、高收缩压和危险分层等可能危险因素,以及病程、男性性别等潜在危险因素对上述初步结论影响的相关临床流行病学研究正在进行中。更多还原

【Abstract】 Objective:To observe the distribution characteristic of meridian pattern in senile hypertension of 203 cases patients and their correlation with baPWV and to evaluate the relational grade of meridian pattern to arterial stiffness. Method:203 cases hypertension patients were divided into four groups according to diagnostic criteria of meridian pattern and blood stasis pattern: meridian pattern group, blood stasis group, meridian pattern group plus blood stasis group and normal group. And full collection of TCM syndromes and relative records were completed in unity. The baPWV (pulse wave velocity) was measured by colin automatic arteriosclerosis determinator made by Japan. The distribution characteristic of meridian pattern in hypertension and their relational grade of meridian pattern to arterial stiffness were observed. Result:1. The constituent ratio of these groups were different. The constituent ratio of meridian pattern group plus blood stasis group was the highest (0.429). Comparison between meridian pattern groups and non-meridian pattern groups showed no significant difference in BMI, WHR number of smoking cases, diastolic pressure and mean arterial pressure(P>0.05).While there were significant difference in Age, gender, systolic pressure, and pulse pressure between these two groups (P<0.05). Age, male gender, systolic pressure, pulse pressure and baPWV of meridian pattern groups were relative higher than those of non-meridian pattern group(P<0.05 or <0.01). 2. Age, gender, systolic pressure, pulse pressure and baPWV predictive factor for meridian pattern, while smoking, BMI, diastolic pressure and mean arterial pressure had no relationship with the onset of meridian pattern. Age, pulse pressure and baPWV were three risk factors which predicted the onset of meridian pattern in hypertension respectively. The most influential factor was baPWV among these. Conclusion: 1.Meridian pattern and the compound patterns integrated with blood stasis were relative common in senile hypertension. 2.There was possible correlation between meridian pattern in senile hypertension and arterial stiffness. Non-conditional logistic regression model was not able to be built due to relative insufficient sample size. As a result, clinical epidemiology research on possible risk factors like enlarging sample size, deeper analysis in age, high systolic pressure and risk stratification and potential risk factors like course and male gender, which could influence the conclusion mentioned above had been undertaking.更多还原