53例进展性脑梗死痰瘀阻络证与颈动脉斑块、血脂及凝血功能异常的相关性研究

Correlation Research on 53 Cases of Progressive Cerebral Infarction of Phlegm and Blood Stasis Resistance Collaterals Syndrome with Carotid Artery Plaque and Blood Lipid and Blood Coagulation Function the Risk Factors of Stroke Onset

目的观察进展性脑梗死痰瘀阻络证与颈动脉斑块、血脂及凝血功能等发病危险因素的相关性。方法145例脑梗死急性期患者按照西医诊断标准和中医证候诊断标准分为进展组53例和非进展组92例,入院后常规查颈动脉超声、血脂、凝血功能。比较两组在发病相关危险因素如高血压、糖尿病、颈动脉斑块、血脂、凝血功能方面的差异。结果在高血压、糖尿病、颈动脉斑块方面,进展组与非进展组比较有显著差异(P<0.05);在血脂方面,进展组与非进展组在总胆固醇和低密度脂蛋白的比较有显著性差异(P<0.01和P<0.05);在凝血功能方面,进展组与非进展组在凝血活酶时间(APTT)和D-二聚体(D-D)的比较有显著性差异(P<0.01)。结论痰瘀阻络证是脑梗死的常见中医证候,无论是进展性还是非进展性均与高血压、糖尿病、血脂和凝血功能等发病危险因素有一定的相关性。但进展性脑梗死与高血压、糖尿病、颈动脉斑块、总胆固醇、低密度脂蛋白、APTT、D-D的相关性明显高于非进展性脑梗死,提示我们在临床上对这类具有高危因素的患者要早识别、早干预,以改善患者的预后。

Objective： To discuss the correlation between progressive cerebral infarction of phlegm and blood stasis resistance collaterals syndrome with carotid artery plaque and blood lipid and blood coagulation function the risk factors of stroke onset. Methods： According to diagnostic criteria of traditional Chinese medicine （TCM） and western medicine, 145 cases of patients with acute phase of cerebral infarction were divided into progressive group of 53 cases and the non-progressive group of 92 eases. After admission,they received regular check including carotid ultrasound, blood lipid, blood coagulation function, etc. The difference between the two groups in regards to the associated risk factors such as hypertension,diabetes,carotid plaques,blood lipid,and blood coagulation func- tion was compared. Results： In terms of high blood pressure ,diabetes, carotid plaques ,there was significant dif- ference （P 〈 0.05 ） between the two groups. In terms of blood lipid, there was significant difference （P 〈 0.01 and P 〈 0.05 ） in the comparison of TCH and LDL between the two groups. In terms of blood coagulation function, there was significant difference （P〈 0.01 ） in the comparison of APTT and D-D between the two groups. Conclusion： Phlegm and blood stasis resistance collaterals syndrome is a common TCM syndrome of cerebral infarction. Whether progressive or non-progressive,there appears some correlation with the pathogenic factors such as high blood pressure, diabetes, blood lipid and blood coagulation function. But the correlation between progressive cere- bral infarction and hypertension,diabetes,carotid artery plaque,TCH,LDL,AFFF, D-D is more significant than that of the non-progressive cerebral infarction. It reminds us to make an early identification and early intervention to this kind of patients with these risk factors in order to improve the prognosis of patients.