脑出血急性期舌象和血液流变学相关性研究

Relationship Between Tongue Conditions and Hemorrheology in Acute Stage of Cerebral Hemorrhage

【目的】通过对脑出血急性期舌象与血液流变学指标的观察,探讨舌象和血液流变学指标的相关性。【方法】选择88例符合诊断标准的患者,在入院后24 h内观察其舌色、舌苔及舌形,并检测血液流变学指标(全血黏度、全血还原黏度、血浆黏度、红细胞压积及纤维蛋白原),分析舌象和血液流变学两者的关系。【结果】胖舌组全血低切黏度显著高于瘦舌组(P<0.05);紫舌组、暗红舌组纤维蛋白原指标显著高于淡红舌组、红舌组(P<0.05或P<0.01);红/绛舌合并与紫/暗红舌合并比较,前者纤维蛋白原明显低于后者(P<0.01);舌苔与血液流变学指标组间比较差异无显著性意义(P>0.05)。【结论】紫、暗舌不仅是中医瘀血的标志,也是血液流变学指标增高的标志,舌象能反映血液流变学的一些变化;而血液流变学指标的测定对阐明舌色的形成原理具有一定价值,脑出血急性期纤维蛋白原升高可做为中医瘀血证辨论诊断的标志之一。

Objective To explore the relationship between tongue conditions and hemorrheology in acute stage of cerebral hemorrhage and to increase the accuracy of tongue conditions for the syndrome differentiation of acute stage of cerebral hemorrhage.Methods Eighty-eight qualified patients were enrolled into this study.The tongue conditions（tongue color,tongue coating and tongue shape） and hemorrheological indexes（whole blood viscosity,whole blood reduced viscosity,plasma viscosity,hematocrit and fibrinogen） were examined,and their relationship was also analyzed.Results The changes of tongue shape was obvious and low-shear whole blood viscosity was increased in the swollen tongue group（P〈0.05 compared with the thin tongue group）.Fibrinogen level was higher in the groups of purplish tongue and dark reddish tongue than that in the groups of light reddish or reddish tongue（P〈0.05 or P〈0.01）.The fibrinogen level in patients with reddish/crimson tongue was lower than that with purplish/dark reddish tongue.There was no significant difference between the tongue coating and hemorrheological indexes.Conclusion Purplish and dark reddish tongues present not only the signs of blood stasis,but also the increase of hemorrheological indexes,indicating that tongue conditions can reflect the changes of hemorrheology.The hemorrheological indexes are helpful to explain the formation of tongue color,and the increase of fibrinogen level in acute stage of cerebral hemorrhage can be used as one of the diagnostic parameters for the syndrome of blood stasis.