气虚血瘀型微栓子阳性急性缺血性脑卒中的病变特征分析

Characteristic Appearance of Qi Deficiency and Blood Stasis Type Stroke with Positive Microembolic Signal

目的分析气虚血瘀型微栓子阳性急性缺血性脑卒中的病变特征。方法选取2015年5月—2018年4月西安医学院第二附属医院神经内三科、上海光华中西医结合医院治未病科、西安·兵器工业五二一医院神经内科、榆林市中医医院脑病科住院收治的120例微栓子阳性急性缺血性脑卒中病人。根据中医辨证分型进行分组,分为气虚血瘀型组(64例)和非气虚血瘀型组(56例)。比较两组病人脉搏波传导速度(PWV)、踝臂指数(ABI)、颈动脉内中膜厚度(IMT)、斑块面积、血脂等。结果两组ABI、斑块面积、斑块分级、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、极低密度脂蛋白胆固醇(VLDL-C)比较差异均无统计学意义(P>0.05);气虚血瘀型组IMT、PWV、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)高于非气虚血瘀型组(P<0.05)。结论气虚血瘀型微栓子阳性急性缺血性脑卒中病人血管功能及结构较非气虚血瘀型更差,IMT、PWV、TC、LDL-C可作为气虚血瘀型辨证的参考依据。

Objective To discuss the characteristic appearance of Qi deficiency and blood stasis(QB)type stroke with positive microembolic signal.Methods A total of 120 stroke patients with positive microembolic signal were divided into QB type group(n=64)and non-QB type group(NQB,n=56).The pulse wave velocity(PWV),ankle-brachial index(ABI),carotid intima-media thickness(IMT),plaque area,and blood lipids were compared between two group.Results There were no significant differences in ABI,plaque area,carotid plaques score,TG,high density lipoprotein cholesterol,and very low-density lipoprotein-cholesterol(VLDL-C)between two groups(P>0.05).However,IMT,PWV,total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)in QB group were more than that in NQB group(P<0.05).Conclusion The vascular function and structure of patients with acute ischemic stroke with microembolism of QB type are worse than those of non-QB type.IMT,PWV,TC,and LDL-C can be used as reference for syndrome differentiation of QB type.