不同中医证型的脑梗死患者血液流变学及血脂指标的比较

目的通过观察不同证型的脑梗死患者血液流变学及血脂指标的比较,总结不同证型检验指标的规律,探讨不同指标与中医证型的关系,为中医辨证提供客观化参考数据。方法对90例脑梗死患者,辨证分为风痰瘀阻型、气虚血瘀型和阴虚风动型,各30例,同时和正常对照组30例分别对血液流变学和血脂指标进行测定。结果脑梗死组的全血黏度、血浆黏度、红细胞比容、纤维蛋白原及红细胞沉降率与正常对照组比较差异均有统计学意义（P〈0.05）;脑梗死组的总胆固醇（TC）、甘油三酯（TG）显著高于正常对照组（P〈0.05）,而其高密度脂蛋白胆固醇（HDL-C）低于正常组（P〈0.01）。风痰瘀阻型组TC、低密度脂蛋白胆固醇（LDL-C）高于气虚血瘀型组、阴虚风动型组（P〈0.05）。气虚血瘀型组、阴虚风动型组的HDL-C低于风痰瘀阻型组（P〈0.05）。结论中风证型与血液流变学变化密切相关,高黏、高凝的血液状态是脑梗死发病的病理基础之一,血液流变学指标的检测可为临床辨证分型的客观化提供一个参考指标,而高TG、低HDL-C是中风的危险因素。

The changes in hemorheology and biochemical indicators on cerebral infarction patients with different Traditional Chinese Medicine distinguish symptom types

Objective To explore the relationship of different indexes and the TCM symptom types, and provide the objective reference dates for Traditional Chinese Medicine diagnoses, the changes in hemorheology and biochemical indexes on cerebral infarction patients with different Traditional Chinese Medicine symptom types were observed, the change rule of different indicators were summarized. Methods 90 cerebral infarction patients with wind phlegm stagnation, deficiency of qi and stagnancy of blood, wind shaking due to deficiency of YIN were divided into three groups according to different types, each group with 30 cases. 30 normal physical examinees were as control group. The indexes of hemorheology and lipids in different groups were determined simultaneously. Results Whole blood viscosity, plasma viscosity, hematocrit, ftbrinogen and erythrocyte sedimentation rate of cerebral infarction group are obvious increased in comparison with control group （ P 〈 0.05）. TC and TG in each cerebral infarction group were higher than the control group （ P 〈 0.05）, but the HDL- C was lower than the control group （ P 〈 0.05）. TC and LDL - C of wind phlegm stagnation group were higher than deficiency of qi and stagnancy of blood group and wind shaking due to deficiency of YIN group （ P 〈 0.05 ）, while in comparison with the HDL - C, the latter was lower than former （ P 〈 0. 05）. Conclusion There is a closely connection between cerebral infarction TCM symptom types and the changes in hemorheology, the state of high blood viscosity, high blood coagulation. These were one of the pathological bases of cerebral infarction. The indexes of hemorheology provides a objective reference for the detection of clinical distinguish symptom types, and high TG, low HDL- C is the risk factors of stroke.