青年急性脑梗死患者中医证型特点以及与血脂、血尿酸关系探讨

The Characteristics of TCM Syndromes in Young Patients with Acute Cerebral Infarction and Their Relationship with Blood Lipids and Blood Uric Acid

目的探讨血脂、血尿酸水平与青年急性脑梗死的相关性,并分析其与不同中医证型的关系及特点。方法选取急性脑梗死的青年患者150例为观察组,随机纳入同期住院的非脑血管疾病患者150例为对照组。分析血脂、血尿酸与青年急性脑梗死相关性,探讨其在不同中医证型中的特点。结果150例青年急性脑梗死患者血清指标中,甘油三酯、载脂蛋白B、脂蛋白a、尿酸均高于对照组,载脂蛋白AⅠ、高密度脂蛋白低于对照组,差异有统计学意义(P<0.05)。经Logistic回归分析后,脂蛋白a和尿酸是青年发生急性脑梗死的独立危险因素(OR=1.582,95%CI=1.191~2.101,P<0.05;OR=1.004,95%CI=1.004~1.011,P<0.05);高密度脂蛋白胆固醇是青年发生急性脑梗死的保护因素(OR=0.108,95%CI=0.03~0.383,P>0.05)。青年急性脑梗死患者各中医证型中,风痰阻络证所占比例最高,为44.67%。痰热腑实证患者的尿酸水平显著高于其他各证型,差异均具有统计学意义(P<0.05);各中医证型间血脂指标差异均无统计学意义(P>0.05)。结论脂蛋白a、尿酸与青年发生急性脑梗死具有关联性,痰热腑实证青年急性脑梗死患者的尿酸水平显著高于其他证型。

Objective:To explore the relationship between blood lipids,blood uric acid levels and acute cerebral infarction in young people,and to analyze their relationship and characteristics with different TCM syndrome types.Methods:A total of 150 young patients diagnosed with acute cerebral infarction were selected as the observation group,and 150 patients with non-cerebrovascular diseases who were hospitalized during the same period were randomly included as the control group.The correlation between blood lipids,blood uric acid and acute cerebral infarction in young people was analyzed,and their characteristics in different TCM syndromes were explored.Results:Among the 150 young patients with acute cerebral infarction,the serum indexes of triglyceride,apolipoprotein B,lipoprotein a,and uric acid were all higher than those of the control group,while apolipoprotein AⅠ,high-density lipoprotein were lower than the control group,and the differences were statistically significant(P<0.05).After logistic regression analysis,lipoprotein a and uric acid were independent risk factors for acute cerebral infarction in young people(OR=1.582,95%CI=1.191~2.101,P<0.05;OR=1.004,95%CI=1.004~1.011,P<0.05);high-density lipoprotein cholesterol was a protective factor for the occurrence of acute cerebral infarction in young people(OR=0.108,95%CI=0.03~0.383,P>0.05).Among the various TCM syndrome types of young patients with acute cerebral infarction,the syndrome of wind-phlegm obstructing the collaterals accounted for the highest proportion of 44.67%.The level of uric acid in patients with syndrome of excessive fu-viscera caused by phlegm-heat was significantly higher than that of other syndrome types,and the difference was statistically significant(P<0.05);there was no statistical difference in blood lipid indexes among all TCM syndrome types(P>0.05).Conclusion:Lipoprotein a and uric acid are related to the occurrence of acute cerebral infarction in young people.The level of uric acid in young patients with acute cerebral infarction with positive phlegm-heat and fu-organism is significantly higher than that of other syndrome types.