气虚血瘀型微栓子阳性急性缺血性脑卒中的病变特征分析  

Characteristic Appearance of Qi Deficiency and Blood Stasis Type Stroke with Positive Microembolic Signal

作　　者：姜超 王婷[3] 罗瑞萍[4] 李豪鹏 杨耀峰 徐中菊 JIANG Chao;WANG Ting;LUO Ruiping;LI Haopeng;YANG Yaofeng;XU Zhongju(The Second Affiliated Hospital of Xi′an Medical College,Xi′an 710038,Shaanxi,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China)

机构地区：[1]西安医学院第二附属医院,西安710038 [2]上海中医药大学附属龙华医院,上海200032 [3]西安电子科技大学经济与管理学院 [4]上海市光华中西医结合医院,上海200052 [5]西安·兵器工业五二一医院 [6]榆林市中医医院

出　　处：《中西医结合心脑血管病杂志》2021年第5期728-730,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：上海市进一步加快中医药事业发展三年行动计划(2018年—2020年)资助项目(No.ZY2018-2020-ZWB-1001);陕西省科技重点研发计划项目(No.2017SF-348);陕西省卫生计生科研基金项目(No.2016D059);上海市浦东新区科委基金创新资助项目(No.PKJ2015-Y47);信立泰药业重点基础课题(No.2016XLT01);榆林市科技支撑项目(No.19-50);陕西省脑疾病防治重点实验室开放基金项目(No.20NBZD02)。

摘　　要：目的分析气虚血瘀型微栓子阳性急性缺血性脑卒中的病变特征。方法选取2015年5月—2018年4月西安医学院第二附属医院神经内三科、上海光华中西医结合医院治未病科、西安·兵器工业五二一医院神经内科、榆林市中医医院脑病科住院收治的120例微栓子阳性急性缺血性脑卒中病人。根据中医辨证分型进行分组,分为气虚血瘀型组(64例)和非气虚血瘀型组(56例)。比较两组病人脉搏波传导速度(PWV)、踝臂指数(ABI)、颈动脉内中膜厚度(IMT)、斑块面积、血脂等。结果两组ABI、斑块面积、斑块分级、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、极低密度脂蛋白胆固醇(VLDL-C)比较差异均无统计学意义(P>0.05);气虚血瘀型组IMT、PWV、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)高于非气虚血瘀型组(P<0.05)。结论气虚血瘀型微栓子阳性急性缺血性脑卒中病人血管功能及结构较非气虚血瘀型更差,IMT、PWV、TC、LDL-C可作为气虚血瘀型辨证的参考依据。Objective To discuss the characteristic appearance of Qi deficiency and blood stasis(QB)type stroke with positive microembolic signal.Methods A total of 120 stroke patients with positive microembolic signal were divided into QB type group(n=64)and non-QB type group(NQB,n=56).The pulse wave velocity(PWV),ankle-brachial index(ABI),carotid intima-media thickness(IMT),plaque area,and blood lipids were compared between two group.Results There were no significant differences in ABI,plaque area,carotid plaques score,TG,high density lipoprotein cholesterol,and very low-density lipoprotein-cholesterol(VLDL-C)between two groups(P>0.05).However,IMT,PWV,total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)in QB group were more than that in NQB group(P<0.05).Conclusion The vascular function and structure of patients with acute ischemic stroke with microembolism of QB type are worse than those of non-QB type.IMT,PWV,TC,and LDL-C can be used as reference for syndrome differentiation of QB type.

关 键 词：急性缺血性脑卒中 气虚血瘀型 微栓子 脉搏波传导速度 踝臂指数 颈动脉内中膜厚度 血脂 

分 类 号：R54[医药卫生—心血管疾病]