缺血性中风证候要素与既往短暂脑缺血发作及血流动力学变化相关性分析  

Correlation between syndrome factors of ischemia stroke and previous transient ischemic attack and hemodynamic changes

作　　者：王乐[1] 陈志刚[1] 张允岭[1] 白文[2] 曹晓岚[3] 张玉莲[4] 赵建军[5] 陈志强[6] 常富业[7] 

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京大学人民医院 [3]山东中医药大学附属医院 [4]天津中医药大学第二附属医院 [5]长春中医药大学第一附属医院 [6]河北医科大学中医院 [7]煤炭总医院

出　　处：《北京中医药大学学报》2010年第9期632-635,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(No.2006CB504805)

摘　　要：目的阐明证候要素与短暂脑缺血(transient ischemic attack,TIA)发作在缺血性中风病中的重要提示作用。方法对54例缺血性中风病患者的证候要素及既往TIA发作情况以及血流动力学相关指标进行回顾性分析,并进行NIHSS评分比较。结果中风病火证与TIA发作与否有相关性(相关系数:-1.61);TIA发作者纤维蛋白原(FIB)明显高于无TIA发作者;颅内血流动力学改变方面,既往有TIA发作与无TIA发作者相比,提供大脑前后循环的血流峰值流速明显减低;中风病火证伴既往TIA发作者治疗前后NIHSS分差低于中风病非火证者。结论中风病火热证发病前无TIA发作等类似症状,即无明显征兆而突然起病;既往有TIA发作者,在缺血性中风急性期内,呈高纤维蛋白原状态,提示TIA发作可能激发了缺血保护机制,而缺血性中风发作时,机体存在一定耐受能力;既往无TIA发作者,火证患者居多,且病情恢复较有TIA发作者差。中风病火热证往往起病急骤,发病前往往无TIA或类似征兆出现,而起病后又易向中风病火毒证方向转化。Objective To expound the important predictive effects of syndrome factors and transient ischemic attack（TIA） in ischemia stroke.Methods A retrospective was carried out to analyse the syndrome factors,previous TIA attack and relevant hemodynamic indexes in 54 patients with ischemia stroke,and then the NIHSS scores were compared.Results The fire syndrome of stroke was correlated to TIA attack or non-attack（related coefficient was-1.61）.The level of fibrinogen（FIB） was higher significantly in the patients with TIA attack than that in the patients without TIA attack.The changes of encephalic hemodynamics showed that the blood peak velocity of brain circulation decreased significantly in the patients with previous TIA attack compared with those without TIA attack.The difference of NIHSS scores before and after the treatment was lower in the TIA patients with fire syndrome of stroke than that in those without fire syndrome.Conclusion Before the attack of fire syndrome of stroke there are no similar symptoms,omen,of TIA attack.The higher level of Fib during acute stage of ischemia stroke in the patients with previous TIA attack indicates that TIA attack may stimulate the ischemia protection mechanism.When ischemia stroke attacks,the body has some tolerance.Among the patients without previous TIA attack,most with fire syndrome and the disease resumption will be poor.The fire syndrome of stroke is urgent suddenly without TIA attack or similar omen,and tends to transform the fire-toxin syndrome of stroke.

关 键 词：证候要素 短暂脑缺血 血流动力学 

分 类 号：R255.2[医药卫生—中医内科学]