Correlation Of Cardiac Risk Factors For Stroke And TCM Syndromes

objective:Analysis of cardiac risk factors for stroke, the intrinsic link OCSP classification, infarct size, TCM classes between TCM syndrome in order to provide the basis for the prevention and treatment of cardiogenic stroke.Methods:Screened from January 2013 to January 2015 during the heart of Traditional Chinese Medicine Hospital Affiliated to Luzhou Medical Branch encephalopathy ischemic stroke (acute phase) treated patients admitted to hospital, a detailed analysis of the clinical data, which includes the general condition of the patient (age, gender, etc.), history taking (hypertension, diabetes, ischemic heart disease, rheumatic heart disease, thrombosis, smoking and drinking history, etc.), laboratory examinations (blood lipids, Hcy, UA, DD, NT-ProBNP, hs-CRP, neck vascular ultrasound, echocardiography, CT or MRI, etc.), the selected patients were divided into cardiogenic stroke group (case group) and non-cardiogenic stroke group (control group) by statistical analysis to explore cardiogenic stroke risk factors (age> 60 years, mitral stenosis, ischemic heart disease, rheumatic heart disease, atrial fibrillation, embolism, Hey, hs-CRP, NT-ProBNP, DD, LVEF, LAD) OCSP classification and relationship with infarct size and cardiac stroke investigate factors associated with the class of TCM and TCM syndromes.Results:1,Univariate analysis showed:age> 60 years, mitral stenosis, ischemic heart disease, rheumatic heart disease, atrial fibrillation, embolism, Hcy, hs-CRP, NT-ProBNP, DD, LVEF, left atrial diameter (LAD) and cardiogenic stroke associated with a statistically significant difference (P<0.05); then the multivariate stepwise logistic regression optimal model to a= 0.05 level for the sector, a total of six factors into the equation (age group, embolism, DD (> lmg/L), LAD (> 35mm), atrial fibrillation, rheumatic heart disease); these six factors based on the size of the partial regression coefficient of order:atrial fibrillation, embolism, rheumatism valvular heart disease, LAD, DD, age, are independent risk factors for cardiac stroke.2,the area under the hs-CRP, NT-ProBNP, DD curve 0.755,0.729,0.7581 respectively; among the top left corner vertex values hs-CRP, NT-ProBNP, DD curve respectively 13.4850 (sensitivity= 0.690, specificity= 0.784),586.07 (sensitivity= 0.643, specificity= 0.753),1.1350 (sensitivity= 0.631, specificity = 0.774), the area under the LAD, LVEF were 0.879,0.321 curve, which is top-left corner LAD curve 33.50, sensitivity= 0.821, specificity= 0.592. 3,cardiogenic stroke group:a large area of infarction accounted for 48.8%, 29.8% in the area of infarction,15.5% of small infarcts, lacunar 6.0%, with non-cardioembolic stroke ratio, the difference was statistically significant (P <0.001). Infarct size and ordinal logistic regression analysis of factors related to the display:Impact DD (> 1mg/L), atrial fibrillation, NT-ProBNP (> 300), hs-CRP (> 10mg/L) of the infarct size was statistically significant (P<0.05). According to the OR, the impact of DD (> lmg/L), atrial fibrillation, NT-ProBNP (> 300), hs-CRP (> 10mg/L) in order to reduce infarct size.4, cardioembolic stroke group:LACI accounted for 2.4%, POCI accounted for 7.1%, PACI accounted for 47.6%, TACI (42.9%), and non-cardiogenic stroke ratio, the difference was statistically significant (P<0.001). With TACI, PACI, POCI, LACI established as the dependent variable logistic regression analysis showed:Impact TACI risk factors include:atrial fibrillation (OR:1.830,95% CI 1.466-10.481), hs-CRP> lOmg/L (OR:2.756,95% CI:1.448-16.948), NT-ProBNP> 300 (OR:0.937,95% CI:0.175-0.983), DD> 1mg/L (OR: 5.340,95% CI:1.100-25.931); influence PACI risk factors include:atrial fibrillation (OR:1.740,95% CI:1.131-23.079), hs-CRP> 10mg/L (OR: 1.147,95% CI:1.220-5.980), NT-ProBNP> 300 (OR:0.523,95% CI: 0.117-0.839); POCI risk factors include:atrial fibrillation (OR:1.427,95% CI: 1.234-32.086), embolism (OR:1.235,95% CI:1.182-15.028); the impact of risk factors LACI:atrial fibrillation (OR:3.940,95% CI:2.034-5.038), LVEF<55% (OR:3.243,95% CI:2.352-6.305).5, cardiogenic stroke group: Lightweight 11.9%,28.6% ordinary type, heavy 45.2 percent, a very severe type of 14.3%, compared with non-cardioembolic stroke, the difference was statistically significant (P<0.001). Ordered logistic regression analysis TCM class classification and related factors showed:age, atrial fibrillation, NT-ProBNP, hs-CRP on TCM typing class was statistically significant (P <0.05). According to the OR, NT-ProBNP, atrial fibrillation, hs-CRP, age> 60 years affect TCM typing class in turn decreases.6, the proportion of the syndrome of TCM cardiogenic stroke group accounted for 15.5% of the wind pyrophlegm Kang, scrambling on 6.0%, Wind & Fire, phlegm organs fact accounted for 16.7%, accounting for 22.6% of wind phlegm, phlegm mind to 31.0%,4.8% Qi and Blood, Yin wind accounted for 3.6%, no significant difference (P> 0.05) and non-cardiogenic stroke each type of distribution of TCM. Chi-square test results and history of different syndromes related diseases relationship cardiogenic stroke group show:cardioembolic stroke group, mostly wind phlegm syndrome rheumatic mitral stenosis and valvular heart disease, and cardiac compared to other syndromes stroke group difference was statistically significant (P<0.05). ANOVA analysis showed that the secondary check indicators and cardiogenic stroke results show the relationship between different syndromes:Hcy in the wind, fire disturbance permits increased significantly in comparison with other syndromes difference was statistically significant (P<0.05), NT-ProBNP and DD by mind in phlegm syndrome was significantly elevated compared with other syndromes with ratio, the difference was statistically significant (P<0.05).Conclusions:1, age> 60 years, mitral stenosis, ischemic heart disease, rheumatic heart disease, atrial fibrillation, embolism, Hcy, hs-CRP, NT-ProBNP, DD, LVEF, left atrial diameter (LAD) were risk factors for cardiac stroke, in which atrial fibrillation, history of thrombosis, rheumatic heart disease, LAD (> 35mm), DD (> 1mg/ L), age (> 60 years) for cardiogenic independent risk factor for stroke.2, hs-CRP, NT-ProBNP, DD, LAD has a diagnosis of cardiogenic stroke predictive value, and higher sensitivity LAD, hs-CRP, NT-ProBNP, DD higher specificity. 3, cardiogenic stroke than non-cardioembolic stroke occurs more infarction, risk factors DD (> 1mg/L), atrial fibrillation, NT-ProBNP (> 300), hs-CRP (> lOmg large/L) impact on infarct size, DD level the greatest impact, and DD<1mg/L, NT-ProBNP<300, hs-CRP<10mg/L as well as in patients with noncardioemb-olic stroke in patients with atrial fibrillation a major low-risk area of infarction.4, cardiogenic stroke group than in the group of non-cardiogenic stroke PACI, TACI high proportion of AF risk factors for each type of impact OCSP are larger, hs-CRP, NT-ProBNP level of TACI and PACI greater impact on the larger DD levels on TACI.5, TCM class type:cardiogenic stroke group was larger and more heavy, age, atrial fibrillation, NT-ProBNP, hs-CRP effect on TCM typing class, which, NT-ProBNP greatest impact; and age<60 years of age, NT-ProBNP<300, hs-CRP<10mg/L as well as non-AF patients a more severe type of risk is low.6, cardiogenic stroke group by phlegm mind in the highest proportion of phlegm, cardiogenic stroke group, mostly wind phlegm syndrome rheumatic mitral stenosis and valvular heart disease, Hey in the wind, fire disturbance permit increased significantly, whereas NT-ProBNP and DD increased significantly compared with the dampness of the certificate by phlegm mind.