摘要
目的探讨急性脑梗死（ACI）不同中医证型患者血栓常规的变化及其意义。方法对256例ACI患者进行中医辨证分型,以及血栓常规[包括凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）、D-二聚体、血管性血友病因子（v WF）和抗凝血酶Ⅲ（ATⅢ）]检测。对不同中医证型亚组之间的血栓常规结果及与正常对照组进行比较。结果本组ACI患者分为风火上炎证53例、风痰瘀阻证68例、痰热腑实证44例、气虚血瘀证47例和阴虚风动证44例。与正常对照组比较,各型亚组的APTT、ATⅢ水平明显降低,血Fib、D-二聚体、v WF水平明显升高（P〈0.05~0.01）,PT、TT的差异无统计学意义（均P〉0.05）;各型亚组之间PT、APTT和TT的差异无统计学意义。风痰瘀阻证亚组的血D-二聚体和v WF水平明显高于其他4亚组（P〈0.05~0.01）;风痰瘀阻证亚组的血Fib水平明显高于、血ATⅢ水平明显低于风火上炎证、气虚血瘀证和阴虚风动证亚组（P〈0.05~0.01）,但与痰热腑实证亚组的血Fib、ATⅢ水平无统计学差异（均P〉0.05）。结论 ACI风痰瘀阻证型患者的血D-二聚体和v WF水平升高最明显,其可作为ACI风痰瘀阻证分型的参考指标。
Objective To explore the changes and their significance of thrombotic markers in different Chinese medical syndrome types patients with acute cerebral infarction （ACI）. Methods Two hundred and fifty-six patients with ACI were typed in accordance with different Chinese medical syndrome types. Thrombotic markers of all the subjects were detected, including prothrombin time （ PT）, activation part thrombin time （ APTT）, thrombin time （T＇F）, fibrinogen （Fib）, D-dimer, von willebrand factor （vWF）, and autithrombin Ⅲ （ATⅢ）. Those markers were compared among different Chinese medical syndrome types and with those of the normal control group. Results Among ACI patients were divided into the wind- fire upward-invading syndrome（53 cases）, the wind-phlegm- stasis syndrome （68 cases） , the phlegm-heat-bowel excess syndrome （44 cases） , the qi-deficiency and blood -stasis syndrome （47 cases） and the yin-deficieney and wind syndrome（ 44 cases）. Compared with the normal control group, the levels of AFTT and ATm in all the syndrome types were found to decrease apparently （ P 〈 0. 05 - 0. 01 ）, and level of Fib, D-dimer and vWF to increase considerably （P 〈 0. 05 - 0.01 ） , and PT and TT made no sense in statistics （ all P 〉 0. 05 ）. The differences of PT, APTT and TT among different syndrome types were not statistically significantly. The levels of D-direct and vWF in patients with the wind-phlegm-stasis syndrome group were apparently higher than those in patients with the other four syndrome type groups （P 〈 0. 05 - 0.01 ）. The level of Fib in the wind-phlegm-stasis syndrome was obviously higher than those of the wind - fire upward - invading syndrome group, the qi - deficiency and blood-stasis syndrome and the yin - deficiency and wind syndrome group while the level of AT Ⅲ was just the oppsite （P 〈 0. 05 - 0.01 ）. The levels of Fib and AT m in the wind-phlegm-stasis syndrome were discovered to have no statistic difference with phlegm-heat-bowel excess syndrome group （ all P 〉 0.05 ）. Conclusions The levels of D-dimer and vWF in wind-phlegm-stasis syndrome are increased most apparently. Therefore, D-dimer and vWF could be taken as the reference to type the wind-phlegm-stasis syndrome.
出处
《临床神经病学杂志》
CAS
北大核心
2014年第6期458-460,共3页
Journal of Clinical Neurology
基金
第二批江苏省优秀中青年中医临床人才研修专项课题(YX1252)
关键词
急性脑梗死
血栓常规
中医证型
acute cerebral infarction
thrombotic markers
Chinese medical syndrome types
