急性缺血性脑卒中中医常见证型血清学相关指标变化临床研究  

A clinical study on the changes of serological indexes of Chinese medicine commonly witnessed in acute ischemic stroke

作　　者：杨泳 杨惠卿 YANG Yong;YANG Huiqing(Department of Traditional Chinese Medicine,Beijing Daxing District People’s Hospital,Beijing 026000,China)

机构地区：[1]北京市大兴区人民医院中医科,北京026000

出　　处：《陕西中医》2024年第1期55-58,66,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：北京市卫生与健康科技成果和适宜技术推广项目(2018-TG-68)。

摘　　要：目的:探究急性缺血性脑卒中(AIS)中医常见证型血清N末端前脑钠肽(NT-ProBNP)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、纤维蛋白原(Fib)变化,同时分析临床意义。方法:选择110例AIS患者,依据《缺血性中风证候要素诊断量表》将其分为四种常见证型。所有受试者均于入院后收集其临床资料,采集空腹静脉血,测定NT-ProBNP、CRP、Fib、Hcy水平,对比各证型患者上述水平的差异性,同时分析与各证型的关系。结果:经分析,各证之间NT-ProBNP水平:风痰瘀阻证>风痰火亢证、气虚血瘀证、痰热腑实证(均P<0.05);风痰火亢证>痰热腑实证(P<0.05),其余各证之间相比无统计学差异(P>0.05)。各证之间Fib水平:风痰瘀阻证>气虚血瘀证、痰热腑实证(均P<0.05);风痰火亢证>痰热腑实证(P<0.05),其余各证之间相比无统计学差异(P>0.05)。各证之间Hcy、CRP水平:痰热腑实证>风痰瘀阻证>气虚血瘀证>风痰火亢证,两两相比具有统计学差异(均P<0.05)。四种证型患者的血清学指标异常率两两相比无统计学差异(P>0.05)。风痰火亢证与高血压、NT-ProBNP、CRP、Hcy关系密切;气虚血瘀证与Fib关系密切;风痰瘀阻证与NT-ProBNP、冠心病、Fib、Hcy关系密切;痰热腑实证与CRP、Hcy关系密切(P<0.05)。结论:在AIS各证型中,风痰瘀阻证患者占比最多,痰热腑实证患者占比最少。风痰火亢证的危险因素为NT-ProBNP、冠心病、Fib、Hcy,痰热腑实证的危险因素为CRP、Hcy,气虚血瘀证的危险因素为Fib,风痰瘀阻证的危险因素为NT-ProBNP、冠心病、Fib、Hcy。Objective:To explore the changes of serum NT-ProBNP,CRP,Fib and Hcy of TCM common witness type in acute ischemic stroke,and analyze the clinical significance.Methods:A total of 110 patients with acute ischemic stroke(AIS)were selected and divided into four common witness types according to the“Ischemic Stroke Syndrome Elements Diagnostic Scale”.Clinical data of all subjects were collected after admission,fasting venous blood was collected,and the levels of NT-ProBNP,homocysteine(Hcy),C-reactive protein(CRP)and fibrinogen(Fib)were determined.The differences of the above levels in patients with different syndrome types and the control group were compared.Results:After analysis,NT-ProBNP level among the syndrome:wind phlegm-stasis syndrome>wind phlegm-fire hyperactivity syndrome,Qi deficiency and blood stasis syndrome,phlegm-heat fu-organs demonstration(all P<0.05).Evidence of hyperactivity of wind phlegm and fire>phlegm-heat fu organs(all P<0.05),there was no difference among the other syndroms(P>0.05).The Fib level among all syndroms:wind phlegm-stasis syndrome>Qi deficiency and blood stasis syndrome,phlegm-heat fu-organs(all P<0.05).Syndrome of hyperactivity of wind phlegm and fire>phlegm-heat fu organs(P<0.05),there was no difference among the other syndroms(P>0.05).The levels of Hcy and CRP among all syndroms were:phlegm-heat fu-organs>syndrome of wind-phlegm-stasis>syndrome of qi deficiency and blood-stasis>syndrome of wind-phlegm-fire hyperactivity,with statistical difference(all P<0.05).There was no significant difference in the abnormal rate of serological indexes among the four syndrome types(P>0.05).The syndrome of wind-phlegm-fire hyperactivity is closely related to hypertension,NT-ProBNP,CRP and Hcy.Qi deficiency and blood stasis syndrome is closely related to Fib.The syndrome of wind-phlegm-stasis is closely related to NT-ProBNP,coronary heart disease,Fib and Hcy.The phlegm-heat fu-organs were closely related to CRP and Hcy(P<0.05).Conclusion:Among the AIS syndrome types,the proportion of patients

关 键 词：急性缺血性脑中风 辨证分型 血清N末端前脑钠肽 C反应蛋白 纤维蛋白原 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]