脑卒中高危人群空腹血糖水平对颈动脉斑块形成的影响及中医证型分布特征

Effects of different fasting blood glucose levels on carotid plaque formation and the distribution characteristics of traditional Chinese medicine syndrome types in population with high risk of stroke

关键词:  脑卒中高危人群  空腹血糖  独立危险因素  颈动脉斑块  中医证型

Key words:  population with high risk of stroke  fasting blood glucose  independent risk factor  carotid plaque  traditional Chinese medicine syndrome type

摘要:

[目的]研究脑卒中高危人群空腹血糖（FBG）水平对颈动脉斑块形成的影响及中医证型分布特征。[方法]选取2012年6月至2015年3月北京王佐镇、蒲黄榆、方庄、花乡、大红门、东铁营社区卫生服务中心符合脑卒中高危诊断者5 090例作为研究对象，进行统一的问卷调查、体格检查、实验室检验、颈动脉超声检查、中医症状采集；依据FBG水平分级标准；比较不同FBG水平对颈动脉斑块形成的影响、不同FBG水平下斑块形成者中医证型分布特征。[结果]在有无颈动脉斑块形成的人群间，FBG分级水平结果存在统计学差异（P<0.01）；以正常血糖（NFG）为基准，校正其他危险因素和影响因素后，空腹血糖受损（IFG）斑块形成风险为NFG的1.352倍[95% CI（1.165，1.570），P<0.01]，糖尿病（DM）斑块形成风险为NFG的1.552倍[95% CI=（1.328，1.814），P<0.01]；在IFG痰湿证有斑块例数所占百分比大于无斑块例数所占百分比（P<0.05），在DM血瘀证、内火证有斑块例数所占百分比大于无斑块例数所占百分比（P<0.05）。[结论]IFG和DM可能都是颈动脉斑块形成的独立危险因素，与其他证型比较，IFG人群中痰湿证，DM人群中血瘀证、内火证，可能与颈动脉斑块形成具有更强的相关性。

Abstract:

[Objective] To study the effects of different fasting blood glucose (FBG) levels on carotid plaque formation and the distribution characteristics of traditional Chinese medicine (TCM) syndrome types in population with high risk of stroke.[Methods] From June 2012 to March 2015,5 090 patients with diagnosis of high risk of stroke from community health service centers of Wangzuozhen,Puhuangyu,Fangzhuang,Huaxiang,Dahongmen,and Dongtieying in Beijing were selected,applied unified questionnaire,physical examination,laboratory examination,carotid artery ultrasound examination,and TCM symptoms collection. The effects on carotid plaque formationof groups with different FBG levels and the distribution characteristics of TCM Syndrome Types were analyzed.[Results] There was a significant difference shown in the result of FBG level between patients with or without carotid plaque formation (P<0.01). After adjusting other risk factors and influencing factors,impaired fasting glucose (IFG)was 1.352 times the plaque formation risk of normal fasting glucose (NFG)[95%CI(1.165,1.570),P<0.01],and diabetes mellitus (DM) was 1.552 times the plaque formation risk of NFG[95%CI=(1.328,1.814),P<0.01]. On IFG level,patients with phlegm-dampness syndrome showed a higher percentage of plaque cases than that of non-plaque cases(P<0.05),while patients with blood-stasis syndrome and internal-fire syndrome showed a higher percentage of plaque cases than that of non-plaque cases (P<0.05)on DM level.[Conclusion] IFG and DM may both be independent risk factors to carotid plaque formation. Phlegm-dampness syndrome in IFG population,blood-stasis syndrome and internal-fire syndrome in DM population might have stronger correlation with carotid plaque formation than other TCM syndromes.