福州地区汉族人群冠心病血瘀证影响因素的病例对照研究

目的探讨影响福州地区汉族人群冠心病血瘀证易感性的主要因素及其影响强度。方法采用病例对照研究设计,以2009年8月—2010年1月福建省人民医院就诊的新发冠心病血瘀证患者和冠心病非血瘀证患者以及非冠心病非血瘀证的其他疾病患者为研究对象,采用问卷调查、实验室检查收集合格对象冠心病相关影响因素,单因素及多因素非条件Logistic回归方法分析各因素与冠心病血瘀证的关联及关联强度。结果符合纳入标准者403例,其中冠心病血瘀证176例,冠心病非血瘀证123例,非冠心病非血瘀证者104例。单因素分析结果:高年龄、脑力劳动、高血压、高食用油消耗、高食盐消耗、情绪低落、工作压力大、有既往相关病史及凝血酶原时间(PT)、红细胞压积(HCT)异常者患冠心病血瘀证的风险明显高于对照人群,而经常性体育锻炼,睡眠充足是其保护因素。排除年龄、性别的影响后,脑力劳动、高血压、食用油及食盐消耗过多、情绪低落、工作压力大、既往相关病史仍为冠心病血瘀证的危险因素,其关联强度OR值(95%CI可信区间)分别为1.902(1.222～2.959)、2.221(1.181～4.176)、2.945(1.781～4.871)、1.794(1.114～2.890)、3.462(1.555～7.712)、1.517(1.082～2.128)、3.159(1.732～5.764)。在冠心病血瘀证与冠心病非血瘀证的比较中,高食盐消耗,高肉类消耗及工作压力大是血瘀证的危险因素,调整年龄、性别影响后,其关联强度OR值(95%CI可信区间)仍然为1.586(1.051～2.393)、1.801(1.191～2.723)、1.386(1.024～1.876)。结论相对于非冠心病人群,脑力劳动、高血压、食用油及食盐消耗过多、情绪低落、工作压力大、既往相关病史是福州地区汉族人群冠心病血瘀证的易感因素;而相对于中医其他证型,高食盐消耗、高肉类消耗及工作压力大与血瘀证的易感性亦呈正相关。

A Case Control Study of Influential Factors for the Han Population with Coronary Heart Disease of Blood Stasis Syndrome in Fuzhou Area

Objective To study main factors and the influencing extent of the susceptibility of the Han population with coronary heart disease(CHD) of blood stasis syndrome(BSS) in Fuzhou area.Methods A case control study was employed in Fujian People′s Hospital from August 2009 to January 2010.Patients with recent attack of CHD of BSS and of CHD of non-BSS,as well as patients without CHD of non-BSS were recruited as subjects.Correlated factors with CHD were collected using questionnaire and laboratory examinations.The correlation and the correlation strength between each factor and CHD of BSS were analyzed using one-way and multiple-factor unconditional Logistic regression methods.Results Of the 403 patients in line with inclusion criteria,there were 176 patients with CHD of BSS,123 with CHD of non-BSS,and 104 without CHD of non-BSS.Results of one-way analysis were reported as follows.Senility,mental labors,hypertension,excessive consumption of oil and salt,depression,stress,past relevant medical history,abnormal prothrombin time(PT),and abnormal hematocrit(HCT) were high-risk factors for CHD of BSS.Regular physical exercise and adequate sleep were protective factors.Except for the effects by age and sex,mental labors,hypertension,excessive consumption of oil and salt,depression,stress,past relevant medical history were still risk factors for CHD of BSS,with the correlation strength(OR value,95% CI) being 1.902(95%CI 1.222～2.959),2.221(95%CI 1.181～4.176),2.945(95%CI 1.781～4.871),1.794(95%CI 1.114～2.890),3.462(95%CI 1.555～7.712),1.517(95%CI 1.082～2.128),and 3.159(95%CI 1.732～5.764).In the comparison between those with CHD of BBS and those with CHD of non-BBS,excessive consumption of salt and meat,and stress were the risk factors for BSS.After the effects by age and sex were adjusted,the OR value were still 1.586(95% CI 1.051～2.393),1.801(95%CI 1.191～2.723),and 1.386(95%CI 1.024～1.876).Conclusions When compared with the population of non-BSS,the predisposing factors for the Han population with CHD of BSS in Fuzhou area covered mental labors,hypertension,excessive consumption of oil and salt,depression,stress,and past relevant medical history.Compared with other syndrome types in Chinese medicine,positive correlation existed between BSS and excessive consumption of salt and meat,as well as stress.