急性丘脑梗死病人中医证型演变规律与血脂、Lp-PLA2水平动态变化的相关性研究

Correlation Research of Evolution Rules of TCM Syndromes with the Levels of Blood Lipids and Lp-PLA2 in Patients with Acute Thalamic Infarction

目的分析急性丘脑梗死病人中医证型演变规律及其与血脂、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的相关性。方法选取石家庄市中医院103例急性丘脑梗死病人作为观察组,另选取本院体检中心50名相应年龄组非脑血管病体检者为对照组。进行血脂、Lp-PLA2检测,同时进行中医辨证,分析中医证型与血脂、Lp-PLA2水平的相关性。结果急性丘脑梗死病人血脂、Lp-PLA2水平明显高于对照组,风证、火证、痰证和瘀证血脂、Lp-PLA2水平明显高于其他证型;丘脑梗死急性前期临床表现以风证、火证、痰证、瘀证为主,随着病程的延长,风证、火证、瘀证和痰证减少,气虚及阴虚证逐渐增加,急性后期至后遗症期病人以瘀证和痰证出现率最高。结论痰证、瘀证为急性丘脑梗死的病理基础,风证、火证为急性丘脑梗死发病的诱因和/或始发因素。血脂、Lp-PLA2水平的异常可能为急性丘脑梗死病人风火相煽、痰瘀并见等病理要素的理化基础之一。

Objective To analyze the evolution of TCM syndromes in patients with acute thalamic infarction,and its correlation with the levels of serum lipids and lipoprotein-related phospholipase A2(Lp-PLA2).Methods One hundred and three patients with acute thalamic infarction in Shijiazhuang Hospital of Traditional Chinese Medicine were selected as the observation group,and 50 age-matched cases with non-cerebrovascular disease were selected as the control group.Blood Lipids and Lp-PLA2 were detected,and TCM syndrome differentiation was conducted simultaneously.The correlation between TCM syndrome type with lipid and Lp-PLA2 level was analyzed.Results The levels of serum lipids and Lp-PLA2 in patients with acute thalamic infarction were higher than those in control group.The levels of lipids and Lp-PLA2 in wind syndrome,fire syndrome,phlegm syndrome,and blood stasis syndrome were significantly higher than those in the other syndrome.The most common TCM syndrome was wind syndrome,fire syndrome,phlegm syndrome,and blood stasis syndrome in earlier stage of acute thalamic infarction.As the course lengthened,the wind syndrome,fire syndrome,and phlegm syndrome decreased,and the syndrome of Qi deficiency and Yin deficiency increased.The most common TCM syndrome was blood stasis and phlegm from the late acute stage to the sequela stage.Conclusion Phlegm syndrome and blood stasis syndrome are the pathological basis of acute thalamic infarction,while wind syndrome and fire syndrome are the inducement and/or initiating factors of acute thalamic infarction.Abnormal levels of serum lipids and Lp-PLA2 may be one of the physicochemical bases of the pathological elements such as wind-fire fan,phlegm and blood stasis in patients with acute thalamic infarction.