急性脑梗死中医证型与血尿酸水平关系的研究

Study of relationship between differential diagnosis of acute cerebral infarction and serum uric acid level

目的 探讨急性脑梗死 (ACI)患者中医辨证分型与血清尿酸水平的关系。方法 10 2例ACI患者辨证分型为肝阳上亢 18例 ,风痰瘀阻 2 1例 ,痰热腑实 2 0例 ,气虚血瘀 2 8例 ,阴虚风动 15例 ,测定各型患者血清尿酸含量 ,并与 2 2例健康体检者作对照。结果 对照组与ACI患者比较 ,两者间高尿酸血症的检出率无显著性差异 ( 2 =2 .5 2 ,P >0 .0 5 ) ,但气虚血瘀型、风痰瘀阻型检出率高于对照组 ,有显著性差异 (P均 <0 .0 5 ) ;阴虚风动型血尿酸水平低于对照组 ,风痰瘀阻型、气虚血瘀型高于对照组 ,均有显著性差异 (P <0 .0 1或 0 .0 5 ) ,肝阳上亢组型、痰热腑实型与健康对照组比较无显著性差异 (P >0 .0 5 )。结论 以“痰”、“瘀”为主证型的ACI患者血尿酸水平较其他证型偏高 ,提示高尿酸血症有血瘀、痰凝等证候者 ,降低血清尿酸水平对保护血管内皮细胞、预防脑卒中可能有临床意义。

Objective It is to discuss the relationship between the differential diagnosis of acute cerebral infarction (ACI) and the serum uric acid level.Methods 102 patients with ACI were divided into hyperactivity of the liver-yang type (18 cases), obstruction of wind-phlegm type (21 cases), phlegm-heat and Fu-organ type (20 cases), Qi-deficiency and blood stasis type (28 cases) and Yin-deficiency and wind-stir type (15 cases). Then the serum uric acid contents of the patients were measured and compared with healthy persons (22 cases) (control group).Results There was no obvious difference in the detection rate of serum uric acid between the two groups (χ2=2.52, P<0.05). But the detection rates of Qi-deficiency and blood stasis type and Yin-deficiency and wind-stir type were higher than that of control group (P<0.05). The serum uric acid level of Yin-deficiency and wind-stir type was lower and that of obstruction of wind-phlegm type and Qi-deficiency and blood stasis type than that of control group (P<0.05 or P<0.01). There was no obvious difference among the control group, hyperactivity of liver-yang type and phlegm-heat and Fu-organ type (P>0.05).Conclusion The serum uric acid levels of patients with phlegm and stasis as main syndrome are higher than those of other diagnosis. To the patients with overmany uric acid accompany with blood stasis and phlegm obstruction, debasing the serum uric acid level may have clinical significance on protecting the vas endothelium cells and preventing ACI.