中医证候、高敏C反应蛋白和氧化低密度脂蛋白与高血压患者发生脑梗死的相关性研究

摘要

Objective To study the correlation between traditional Chinese medicine (TCM) syndrome, high sensitivity C - reactive protein (hsCRP) , oxidized low - density lipoprotein (oxLDL) and cerebral infarction. Methods Clinical data were compared between hypertension group and hypertension complicated with cerebral infarction group. Differences and correlations between TCM syndrome, hsCRP, oxLDL and cerebral infarction in patients with hypertension were analyzed. Results The positive rate of syndrome of phlegm turbidity,heat accumulation and endogenous liver wind were increased and qi deficiency syndrome were decreased in hypertension complicated with cerebral infarction group, compared to hypertension group (P<0. 05 or P<0. 01). There was a high proportion of single and double syndromes in hypertension group,and there was a high proportion of multitude syndromes in cerebral infarction group (P<0. 01). Correlation analysis showed that cerebral infarction was positively correlated with syndrome of phlegm turbidity, heat accumulation,endogenous liver wind and the number of concurrently TCM syndrome,and it was negatively correlated with qi deficiency syndrome (P<0. 05 or P<0. 01). The levels of hsCRP and oxLDL in cerebral infarction was higher compared with hypertension group (P<0. 01). Furthermore, there was a positive correlation between hsCRP, oxLDL and cerebral infarction in patients with hypertension (P<0. 01). After controlling variables gender, age and blood pressure levels, there was also a positive correlation between hsCRP and oxLDL (r=0. 864,P<0. 01). Conclusion Occurrence of cerebral infarction had a certain correlation with changes of TCM syndrome,hsCRP and oxLDL. And TCM syndrome combined with laboratory indicators detection was beneficial for early assessment and prediction of cerebral infarction risk in patients with hypertension.%目的 研究中医证候、高敏C反应蛋白(hsCRP)和氧化低密度脂蛋白(oxLDL)与高血压患者发生脑梗死的相关性,及其对脑梗死风险评估的作用和意义.方法 比较高血压和高血压合并脑梗死两组患者的临床资料,分析两组患者的中医证候、hsCRP和oxLDL的差异及与发生脑梗死的相关性.结果 脑梗死组的痰浊证、郁热证、肝风内动证发生率显著高于高血压组,气虚证发生率显著低于高血压组(P<0.05或P<0.01).高血压组以单证和两证相兼为主,脑梗死组的三证和四证相兼情况较多(P<0.01).相关分析提示,痰浊证、郁热证、肝风内动证和兼证个数与发生脑梗死呈正相关,气虚证与发生脑梗死呈负相关(P<0.05或P<0.01).实验室指标方面,脑梗死组的血清hsCRP和oxLDL浓度均显著高于高血压组(P<0.01).无控制变量的Pearson相关分析显示,hsCRP和oxLDL均与高血压病患者发生脑梗死呈显著正相关(P<0.01);当控制性别、年龄和血压水平等变量后二者仍然与发生脑梗死呈显著正相关(P<0.01),并且血清hsCRP和oxLDL之间呈显著正相关(r=0.864,P<0.01).结论 中医证候和血清hsCRP、oxLDL的变化与高血压患者发生脑梗死存在一定相关性,中医辨证结合实验室指标检测对于早期评估和预测高血压患者发生脑梗死的风险具有积极意义.