冠状动脉不同病变程度患者中医脉图特征参数分析

目的通过分析冠心病疑似患者冠状动脉不同病变程度的脉图特征参数,探讨冠状动脉病变程度与脉图特征的相关性,挖掘脉诊的临床价值。方法采用ZBOX-Ⅰ型脉象数字化采集分析仪采集脉象样本,依据冠状动脉病变程度评分分为冠脉正常组、冠脉非严重病变组、冠脉严重病变组。采用非参数检验分析3组脉图时域特征参数差异。结果与冠脉正常组及冠脉非严重病变组比较,冠脉严重病变组脉图时域参数t1、t1/T、t1/t4显著增大(P<0.01),h5/h1显著减小(P<0.05);与冠脉非严重病变组比较,冠脉严重病变组t5/t4、h4/h1显著增大(P<0.05),T、h5/h1显著减小(P<0.01),t4显著减小(P<0.05)。基于脉图时域特征参数,运用随机森林的模式识别方法,建立冠状动脉不同病变程度的评估模型,该模型对3组不同冠状动脉病变程度的平均识别率为77.94%。结论冠状动脉不同病变程度患者的脉图时域特征存在显著差异,其参数变化可反映不同分组患者的心血管特征。脉诊的无创检测技术可作为现有心血管病变检查技术的辅助工具,在心血管疾病筛查和监测中发挥作用。

Analysis on Characteristic Parameters of TCM Pulse Patterns in Patients with Different Degrees of Coronary Artery Disease

Objective To discuss the correlation between the degree of coronary artery disease and the characteristics of pulse patterns by analyzing the characteristic parameters of different degrees of coronary artery in patients with coronary heart disease;To explore the clinical value of pulse diagnosis.Methods Pulse samples were collected by ZBOX-Ⅰpulse digital acquisition analyzer,and they were divided into three groups according to the severity of coronary artery disease(normal coronary artery group,non-severe coronary artery disease group,severe coronary artery disease group).The non-parametric test method was used to analyze the difference of the time-domain characteristic parameters of the three groups of pulse patterns.Results Compared with the normal coronary artery group and the non-severe coronary artery disease group,the time-domain parameters t1,t1/T and t1/t4 of the severe coronary artery disease group significantly increased(P<0.01),and h5/h1 significantly decreased(P<0.05);Compared with non-severe coronary artery disease group,t5/t4 and h4/h1 significantly increased in severe coronary artery disease group(P<0.05),and T and h5/h1 significantly decreased(P<0.01)and t4 decreased significantly(P<0.05).Based on the time-domain characteristic parameters of the pulse map,the pattern recognition method of random forest was used to establish an evaluation model of different degrees of coronary artery stenosis.The average recognition rate of the three groups of coronary artery disease was 77.94%.Conclusion There are significant differences in the time-domain characteristics of the patients with different degrees of coronary artery disease.The parameter changes can reflect the cardiovascular characteristics of different groups of patients.The non-invasive detection technique of pulse diagnosis is expected to be an auxiliary tool for the existing cardiovascular disease examination technology,which plays a certain role in the screening and monitoring of cardiovascular diseases.