心脑血管危险因素与气虚血瘀证脑卒中患者脑梗死面积及其认知功能障碍的关联性分析  

Correlation Analysis of Cardiovascular Risk Factors,Cerebral Infarction Area and Cognitive Dysfunction in Qi-Xu-Xue-Yu Stroke Patients

作　　者：吴旋[1] 陈云欢[1] 林恒山 蔡梅玉[1] 程颖[1] 汪欣[1] 

机构地区：[1]福建中医药大学附属康复医院,福建省康复产业研究院/福建省康复技术重点实验室,福建福州350001

出　　处：《中国医学创新》2016年第8期5-8,共4页Medical Innovation of China

基　　金：2013年福建中医药大学临床类校管科研课题(XB2013049);2013年福建省卫生厅中医药科研项目(wzkf201308);2015年福建中医药大学重点学科(脑血管疾病康复的基础和临床研究)专项校管课题(X2014076)

摘　　要：目的:观察心脑血管危险因素同型半管氨酸、纤维蛋白原、颈动脉内中膜厚度(IMT)与气虚血瘀证脑卒中患者脑梗死面积及其认知功能障碍的相关性。方法:选取2015年1-6月本院收治的急性脑梗死患者150例,采用蒙特利尔认知评估量表(Mo CA)评估认知功能,采用颈动脉彩超检测颈动脉IMT值,全自动生化分析仪检测血清同型半胱氨酸(Hcy),全自动凝血分析仪检测血浆纤维蛋白原(FIB),机械系统动力学自动分析法(ADAMS)测量脑梗死面积,观察并比较结果。结果:颈动脉彩超资料结果显示,患者以颈动脉硬化为主(硬化+斑块,108/150),其中Mo CA评分在颈动脉正常者和颈动脉硬化组比较差异无统计学意义(P>0.05),斑块形成组与颈动脉正常组、颈动脉硬化组比较差异有统计学意义(P<0.05);认知功能正常组颈动脉IMT、Hcy、FIB与认知功能损伤组比较差异有统计学意义(P<0.05),颈动脉IMT、Hcy、FIB在不同程度的脑梗死面积中比较差异有统计学意义(P<0.05)。结论:早期常规检测颈动脉IMT值、Hcy、FIB,有助于早期辅助预测气虚血瘀型脑卒中患者的危重程度及对认知功能的影响,对改善脑卒中患者的预后及认识功能水平意义重大。Objective： To observe the relationship between cardiovascular risk factors： homocysteine, fibrinogen and carotid IMT value with cerebral infarction area and cognitive dysfunction in qi-xu-xue-yu stroke patients.Method： 150 cases of stroke were selected, the cognitive function was assessed by Montreal Cognitive Assessment （ MoCA ）, the carotid IMT value was detected by carotid artery color ultrasound, the serum homocysteine was detected by automatic biochemical analyzer and the fibrinogen was detected by automatic coagulation analyzer, the cerebral infarction area was measured by Automatic Dynamic Analysis of Mechanical Systems （ ADAMS ） .Result： The results of carotid artery eolour showed the patients were given priority with carotid atherosclerosis （atherosclerosis and plaque, 108/150）, compared with those without carotid atherosclerosis, there was no difference （ P〉0.05 ） of MoCA score in carotid atherosclerosis patients and compared with those without carotid atherosclerosis and with carotid atherosclerosis, the difference was statistically significant （ P〈0.05 ） of MoCA score in carotid plaque group, compared with normal cognitive function, there was statistically significant difference （ P〈0.05 ） of homocysteine, fibrinogen and carotid IMT value in cognitie impairment group, and there was statistically significant difference （ P〈0.05 ） of homocysteine, fibrinogen and carotid IMT value in the different degree of cerebral infarction area.Conclusion： Detecting the carotid IMT values, fibrinoge and homocysteine levels in Qi-Xu-Xue-Yu stroke patients are in favour of objectively judging critical rate of the cerebral infarction and its influence on cognitive function, which has important clinical significance for the recovery of neural function and the cognitive fimction level after cerebral infarction.

关 键 词：气虚血瘀 脑卒中 颈动脉内中膜厚度 纤维蛋白原 同型半胱氨酸 

分 类 号：R277.7[医药卫生—中医学]