缺血性中风急性期证候与颈动脉粥样硬化分级的相关性研究

目的 探讨缺血性中风急性期证候与颈动脉粥样硬化分级的相关性.方法 对95例缺血性中风急性期患者进行证候诊断,并收集颈动脉超声检查结果,建立数据库,应用SPSS19.0分析软件对颈动脉粥样硬化分级与证候的关系进行分析.结果 缺血性中风急性期证候的发生率由高到低依次是痰证、火热证、血瘀证、风证、气虚证、阴虚阳亢证；气虚证患者颈动脉发生狭窄的比率较高,其次为痰证,风证狭窄比率最低；风证、火热证、痰证、血瘀证、气虚证和阴虚阳亢证在颈动脉粥样硬化分级及颈动脉狭窄发生率相近（P＞0.05）；风证与非风证、火热证与非火热证、血瘀证与非血瘀证、阴虚阳亢证与非阳亢证在颈动脉粥样硬化分级及颈动脉狭窄发生率相近（P＞0.05）；气虚证与非气虚证在颈动脉狭窄的发生率相近（P＞0.05）；痰证与非痰证、气虚证与非气虚证在颈动脉粥样硬化分级上的差异有统计学意义（P＜0.05）；痰证与非痰证在颈动脉狭窄的发生率差异有统计学意义（P＜0.01）.逐步回归分析结果提示与颈动脉粥样硬化分级评分有相关性的只有痰证,两者呈正相关.缺血性中风急性期痰证积分越高,则颈动脉粥样硬化分级越高.结论 在缺血性中风急性期表现为痰证、气虚证的患者应尽快完善颈动脉超声检查以指导临床治疗;未来还需要大样本、多中心、多层次的研究来增加研究结果的可信度.

Study on Relationship between Acute Ischemic Stroke Syndromes and the Grading of Carotid Atherosclerosis

Objective： To investigate the relationship between the acute ischemic stroke syndromes and the grading of carotid atherosclerosis. Methods： 95 Patients whose first diagnosis was ＂acute ischemie stroke＂ in Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from August 2012 to August 2013 were included as the observed cases. The result of carotid artery ultrasound as well as the syndrome score were record- ed,a database was established and then SPSS19.0 analysis software was used to analyze the data. Results： Step- wise regression analysis revealed that there was only a positive correlation between the score of the carotid atherosclerosis grading and phlegm syndrome,which means the higher the score of phlegm in acute ischemic stroke ,the higher the grading of the carotid atherosclerosis will be. Conclusion： There is a correlation between the acute stage of ischemic stroke syndromes and the grading of carotid arterial atheroselerosis. Carotid ultrasonic ex- amination results can be used as Acute Ischemic Apoplexy Syndrome objective basis of syndrome diagnosis. Stud- ies with large sample, multi centers, multi level to increase the reliability of the results are needed in the future.