Value of Tongue Color Combined with Sublingual Microcirculation in Predicting the Severity of Mild to Moderate Acute Cerebral Infarction

Objective:To explore the value of tongue color combined with sublingual microcirculation in predicting the severity of mild to moderate acute cerebral infarction(ACI).Methods:From January to December 2022,90 patients with ACI were admitted to the Department of Neurology of Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine.According to the NHISS score on the 5th day of admission,the patients were divided into mild group(35 cases)and moderate group(55 cases).The changes of tongue color and arterial lactate on the 5th day of admission were observed and monitored.Side-stream dark field imaging(SDF)was used to determine the total vascular density(TVD),perfused vascular density(PVD),perfused vascular ratio(PPV)and microvascular flow index(MFI).The multivariate logistic regression analysis was used to screen the risk factors for the severity of ACI,and the receiver operating characteristic curve(ROC)to evaluate their values in predicting ACI severity.Results:There was no significant difference in lactate between the two groups(P>0.05),and the frequency of red tongue in the mild group was higher,and the frequency of red tongue in the moderate group was significantly higher in the dark tongue group(P<0.05).The multivariate logistic regression analysis showed that PVD and PPV were independent risk factors for the severity of mild to moderate ACI(P<0.05).The ROC curve analysis showed that an area under the curve of 0.832 was achieved by the combination of PVD and PPV,which was larger than that of a single factor.Conclusion:Tongue color combined with sublingual microcirculation can be combined to predict the severity of mild to moderate ACI.

Correlation between Different Chinese Medicine Syndromes and Changes in Microcirculation in Septic Shock Patients

Objective： To investigate the correlation between different Chinese medicine （CM） syndromes and variations in microcirculation in septic shock patients. Methods： seventy Septic shock patients were divided into four groups： heat damaging qi-yin group （HDQY, 23 cases）; yin exhaustion and yang collapse group （YEYC, 26 cases）; excessive heat in Fu organ group （EHFO, 10 cases）; and heat damaging nutrient-blood group （HDNB, 11 cases）. Sublingual microcirculation parameters were observed by sidestream dark-field （SDF） imaging and scored by Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） and the Sequential Organ Failure Assessment （SOFA）, and parameters of microcirculation perfusion variations and prognoses were analyzed. Results： Compared with those with qi-yin heat damage, perfused vessel density （PVD） in other groups decreased dramatically （P〈0.05）, and APACHE H scores increased significantly （P〈0.05）. In addition, the recovery time was prolonged substantially （P〈0.05）, and the mixed venous oxygen saturation （SVO2） decreased （P〈0.05）. Blood lactic acid increased significantly （P〈0.05）, and the mixed SVO2 decreased （P〈0.05）, in the YEYC group. Compared with the thermal injury camp blood group, sublingual microcirculation parameter variations showed no obvious difference in the YEYC and EHFO groups （P〉0.05）. There were significant positive correlations between CM syndromes and APACHE Ⅱ scoring in different groups （r=0.512, P〈0.05）. There were negative correlations between PVD and APACHE Ⅱ scoring （r=-0.378, P=0.043）, the proportion of perfused vessels （PPV） and APACHE g scoring （r=0.472, P=0.008）, as well as between the microvascular flow index （MFI） and APACHE Ⅱ scoring （r=-0.424, P=0.023） in different patients. Conclusion： Sublingual microcirculation may serve as a clinical diagnostic parameter of the patient condition, as well as being a prognostic indicator.