急性后循环梗死患者中医体质与CISS病因分型关系研究

Study of relationships between constitution of TCM and CISS in patients with acute posterior circulation infarction

目的探讨急性后循环梗死患者中医体质与中国缺血性卒中亚型(CISS)病因分型的关系。方法对207例急性后循环梗死患者的中医体质、CISS病因分型进行判定,统计其梗死部位、病变血管。结果 207例患者以痰湿、气虚体质多见;CISS病因分型以大动脉粥样硬化(LAA)型居多;与平和质比较,痰湿质、湿热质易发生LAA型脑梗死,差异有统计学意义(P<0.05)。207例患者以椎动脉颅内段血管病变最多;与平和质比较,痰湿质易导致椎动脉颅内段血管病变,差异有统计学意义(P<0.05)。急性后循环梗死患者常见中段梗死;在LAA型中以远段梗死多见,在穿支动脉疾病(PAD)型中以中段梗死多见,差异有统计学意义(P<0.05)。结论急性后循环梗死患者中医体质、CISS病因分型、病变血管、梗死部位分布存在差异;痰湿质是LAA型脑梗死的高危体质,同时也是引起椎动脉颅内段动脉硬化、狭窄、闭塞等病变的高危体质;CISS病因分型中,LAA型脑梗死多见远段梗死,PAD型脑梗死以中段梗死多见。

Objective To investigate the relationship between constitution of TCM and CISS after acute posterior circulation infarction. Methods TCM constitution and CISS of 207 patients with acute posterior circulation infarction were clarified, and the infarction site and diseased vessels were collected statistically. Results Among 207 patients, phlegm dampness and Qi deficiency were commonly seen constitutions; large artery atherosclerosis （LAA） type was in the majority in CISS; compared with harmony constitution, LAA type of cerebral infarction more easily occurred in phlegm dampness constitution and damp heat constitution, the difference was statistically significant （ P 〈 0. 05 ）. Vertebral artery intracranial vascular lesions were the most among 207 cases of patients ; compared with harmony constitution, phlegm dampness constitution more easily cause vertebral artery intracranial vascular lesions, the difference was statistically significant （P 〈 0. 05 ）. Middle segment infarction was more found; distal segment infarction more in LAA type, middle segment infarction more in perforator artery disease （PAD）, the difference was statistically significant（P 〈 0. 05）. Conclusion In acute posterior circulation infarction patients, there are differences in TCM constitution, CISS, affected vessel, infarct location distribution ; phlegm dampness constitution is the high risk for large artery atherosclerosis （LAA） type of cerebral infarction, is also the high risk for vertebral artery intracranial arteriosclerosis, stenosis and occlusion; in CISS, distal segment infarction is more seen in large artery atherosclerosis （LAA） type of cerebral infarction, the middle segment infarction more in perforator artery disease （PAD） of cerebral infarction.