缺血性脑卒中患者中医证型与Crouse积分、血清同型半胱氨酸、凝血功能相关性研究

目的:探讨缺血性脑卒中患者中医证型与Crouse积分、血清同型半胱氨酸(Hcy)、凝血功能的相关性。方法:选取缺血性脑卒中患者96例作为研究对象,对其临床资料、中医证型、实验室检查及颈动脉超声检查结果进行回顾性分析。分析96例入组患者的中医证型分布,比较不同中医证型患者的Crouse积分、血清Hcy、国际标准化比率(INR)、凝血酶原时间(PT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)水平,分析中医证型与以上指标之间的关系。结果:96例缺血性脑卒中患者主要为风痰火亢证、风痰瘀阻证和气虚血瘀证,分别占比26.04%、21.88%和20.83%,分别划分为风痰火亢证组、风痰瘀阻证组和气虚血瘀证组; 三组在性别、合并基础疾病、吸烟史和饮酒史方面比较差异无统计学意义(P>0.05),但气虚血瘀证患者年龄高于风痰瘀阻证和风痰火亢证患者(P<0.05); 三组患者Hcy水平由高到低依次为:气虚血瘀证组>风痰瘀阻证组>风痰火亢证组,差异有统计学意义(P<0.05); 风痰火亢证患者PT、FDP和D-D水平均明显低于风痰瘀阻证和气虚血瘀证患者(P<0.05),三组患者Crouse积分由高到低依次为:风痰瘀阻证组>气虚血瘀证组>风痰火亢证组,差异有统计学意义(P<0.05); 相关性分析结果显示,缺血性脑卒中患者血清Hcy、PT、FDP和D-D水平、Crouse积分之间分别互为正相关性(P<0.05)。结论:Crouse积分、血清Hcy及PT、FDP、D-D等凝血指标在不同中医证型缺血性脑卒中患者中呈不同表达,以上指标可能对于缺血性脑卒中患者中医证型的评估和判断具有一定的指导价值。

Correlation between TCM syndromes and Crouse score,serum Hcy,coagulation function in patients with ischemic stroke

Objective:To explore the correlation between TCM syndromes and Crouse score,serum homocysteine(Hcy),coagulation function in patients with ischemic stroke.Methods:96 patients with ischemic stroke were enrolled as the research objects.The clinical data,TCM syndromes,laboratory examination and carotid ultrasound examination results were retrospectively analyzed.Their distributions of TCM syndromes were analyzed.Crouse scores,serum Hcy, INR,PT,FDP and DD were compared among patients with different TCM syndromes.And the relationship between TCM syndromes and the above indexes was analyzed.Results:TCM syndromes in the 96 patients with ischemic stroke were mainly on wind-phlegm fire-hyperactivity,wind-phlegm stasis and qi-deficiency blood-stasis,accounting for 26.04%,21.88% and 20.83% respectively.The patients with the above three syndromes were divided into wind-phlegm fire-hyperactivity group,wind-phlegm stasis group and qi-deficiency blood-stasis group.The differences in gender,underlying diseases,smoking history and drinking history were not statistically significant among the three groups(P>0.05).The age of patients with qi-deficiency blood-stasis syndrome was older than that in wind-phlegm stasis syndrome group and wind-phlegm fire-hyperactivity syndrome group(P<0.05).Hcy level was the highest in qi-deficiency blood-stasis group,followed by wind-phlegm stasis group and wind-phlegm fire-hyperactivity group(P<0.05).The levels of PT,FDP and D-D in patients with wind-phlegm fire-hyperactivity syndrome were significantly lower than those in wind-phlegm stasis syndrome and qi-deficiency blood-stasis syndrome group(P<0.05).Course scores were the highest in patients with wind-phlegm stasis syndrome,followed by qi-deficiency blood-stasis syndrome and wind-phlegm fire-hyperactivity syndrome(P<0.05).The results of correlation analysis showed that serum Hcy,PT and FDP were positively correlated with D-D level and Course scores in patients with ischemic stroke(P<0.05).Conclusion: The expression of Crouse score,serum Hcy and coagulation indexes(PT,FDP,D-D)is different in ischemic stroke patients with different TCM syndromes.The above indexes may be of certain guidance value in evaluating and determining TCM syndromes.