急性脑梗死患者血清脂蛋白a、高密度脂蛋白水平与中医证型相关性分析

The correlation between serum high density lipoprotein,lipoprotein levels and TCM syndrome types in patients with acute cerebral infarction

目的分析急性脑梗死(ACI)患者血清高密度脂蛋白(HDL)、脂蛋白(Lpa)水平与中医证型相关性。方法选取2019年1月至2020年1月收治的ACI患者120例作为研究对象,参照《中医病症诊断疗效标准》辨别患者中医证型(风痰阻络证、气虚血瘀证、肝阳暴亢证、痰热腑实证、阴虚风动证),全部患者均检测血清HDL、Lpa水平,并对患者神经功能缺损情况(NIHSS评分)进行评估,对比不同中医证型ACI患者HDL、Lpa水平、NIHSS评分差异,分析ACI患者HDL、Lpa水平与NIHSS评分的相关性。结果120例ACI患者风痰阻络证21例,阴虚风动证27例,痰热腑实证24例,风阳上扰证18例,气虚血瘀证30例;气虚血瘀证、风痰阻络证患者HDL水平低于阴虚风动证、痰热腑实证、风阳上扰证患者,Lpa水平高于痰热腑实证、阴虚风动证、风阳上扰证患者(P<0.05);风痰阻络证HDL水平低于气虚血瘀证患者,Lpa水平高于气虚血瘀证患者(P<0.05);气虚血瘀证、风痰阻络证患者NIHSS评分高于痰热腑实证、阴虚风动证、风阳上扰证患者(P<0.05);经双变量Pearson直线相关检验分析,ACI患者HDL水平与NIHSS呈负相关(r=-0.460,P<0.05);Lpa水平与NIHSS评分呈正相关(r=0.605,P<0.05)。结论ACI患者中医证型与HDL水平降低,Lpa水平升高有关。

Objective To investigate the correlation between serum high density lipoprotein(HDL),lipoprotein(Lpa)levels and TCM syndrome types in patients with acute cerebral infarction(ACI).Methods A total of 120 patients with ACI who were treated in our hospital from January 2019 to January 2020 were enrolled in the study.The TCM syndrome types(wind phlegm obstructing collaterals syndrome,qi deficiency and blood stasis syndrome,hyperactivity of liver Yang syndrome,excessive fu-viscera caused by phlegm-heat syndrome,yin deficiency and wind movement syndrome)were identified according to the《Diagnostic Efficacy Standard of TCM Diseases》,and the serum levels of HDL and Lpa were detected,and the neurological deficit(NIHSS score)was evaluated,the differences of HDL,Lpa and NIHSS scores in ACI patients with different TCM syndromes were compared.Moreover the correlation between HDL,Lpa levels and NIHSS score was analyzed.Results Of the 120 patients with ACI,there were 21 cases of wind phlegm obstructing collaterals syndrome,27 cases of yin deficiency and wind movement syndrome,24 cases of excessive fu-viscera caused by phlegm-heat syndrome,18 cases of hyperactivity of liver Yang syndrome,and 30 cases of qi deficiency and blood stasis syndrome.The HDL levels in patients with qi deficiency and blood stasis syndrome as well as wind phlegm obstructing collaterals syndrome were significantly lower than those in patients with yin deficiency and wind movement syndrome,excessive fu-viscera caused by phlegm-heat syndrome and hyperactivity of liver Yang syndrome,however,the Lpa levels were significantly higher than those of patients with excessive fu-viscera caused by phlegm-heat syndrome,yin deficiency and wind movement syndrome and hyperactivity of liver Yang syndrome(P<0.05).Moreover the NIHSS scores of patients with qi deficiency and blood stasis syndrome as well as wind phlegm obstructing collaterals were significantly higher than those of patients with excessive fu-viscera caused by phlegm-heat syndrome,yin deficiency and wind movement syndrome as well as hyperactivity of liver Yang syndrome(P<0.05).The bivariate Pearson linear correlation analysis showed that HDL levels were negatively correlated with NIHSS scores,(P<0.05),and Lpa levels were positively correlated with NIHSS scores(P<0.05).Conclusion The TCM syndrome types of patients with are related to the decrease of HDL level and the increase of Lpa level.