中医综合治疗合并高血压缺血中风的临床疗效评价及相关实验研究
|
摘要
临床部分
目的
评估中医综合治疗对合并高血压与非合并高血压的急性缺血中风患者神经功能缺损程度、残障水平、生活能力、生存质量和中医症候的影响以及高血压对中医综合方案干预缺血中风疗效的影响。
内容与方法
通过分析“十五”课题后期“急性缺血中风疗效评价RCT临床试验方案”数据库资料,比较中医综合疗法与西医常规治疗不同干预对合并高血压急性缺血中风患者在不同时点NIHSS评分、mRS评分、BI指数、GOS评分、SS-QOL积分、中医症征积分的影响,以期全面评价中医综合方案对高血压性及非高血压性急性缺血中风疾病的干预作用。通过比较有高血压与无高血压缺血中风患者分别接受中医综合治疗后各水平量表评分上的差异,以评估高血压因素对疾病预后及干预方案疗效的影响。
结果
对于合并高血压的缺血中风患者,控制糖尿病史因素,中医综合治疗与西医对照治疗比较,患者在NIHSS、BI、SSQOL上两组之间差异无统计学意义(P>0.05)；在mRS、GOS、SSTCM上两组之间差异有统计学意义(P<0.05；P<0.01)。两组在第60天mRS、GOS,第0天、7天、60天SSTCM上差异有统计学意义(P<0.05)。
对于非合并高血压的缺血中风患者,中医综合治疗与西医对照治疗比较,患者在NIHSS、GOS、BI、SSQOL、SSTCM上两组之间差异无统计学意义(P>0.05)。在mRS上两组之间差异有统计学意义(P<0.05)。两组在第60天、90天mRS,第21天、60天、90天GOS,第90天SSQOL,第60天、90天SSTCM上差异有统计学意义(P<0.05)。
在控制脑卒中史、高胆固醇史,高血压因素对中医综合治疗后患者的NIHSS、BI、SSQOL、SSTCM改变无影响(P>0.05)；对中医综合治疗后患者的mRS、GOS改变有影响(P<0.05)。
结论
中医综合治疗方案能有效减轻合并高血压的缺血中风患者第60天残障水平,改善第7天、第60天中医症状；降低非合并高血压缺血中风患者第21天、60天、90天残障水平,提高第90天生存质量,改善60天、90天中医症状；高血压因素对中医综合治疗缺血中风患者的残障水平有影响,中医综合治疗对降低非高血压性缺血中风患者残障水平疗效更好。
实验部分
目的
通过观察益脑康胶囊干预对动脉粥样硬化性急性缺血中风大鼠行为学、病理学、生化学、组织学相关指标的改变,以客观评价中药益脑康胶囊对动脉粥样硬化性急性缺血中风的防治作用。
内容与方法
观察中药益脑康胶囊对动脉粥样硬化性急性缺血中风大鼠血液及组织中N0、VEGF、PDGF-BB、vWF、TM等动脉硬化及内皮损伤相关因子的影响,以探讨益脑康胶囊发挥缺血中风防治作用的可能机制。
结果
益脑康预防组、益脑康治疗组、立普妥治疗组大鼠脑组织含水量低于AS+ACI模型组,差异有显著统计学意义(P<0.01)。益脑康预防组、立普妥治疗组与AS+ACI模型组比较,血清NO水平增高,差异有统计学意义(P<0.01,P<0.05)；益脑康治疗组与AS+ACI模型组比较,NO水平差异无统计学意义(P>0.05)；益脑康预防组与立普妥治疗组比较,NO水平差异无统计学意义(P>0.05)。三个干预组与AS+ACI模型组比较,血清VEGF、PDGF-BB水平下降,差异有统计学意义(P<0.01,P<0.05)；三个干预组之间比较,血清VEGF、PDGF-BB水平差异无统计学意义(P>0.05)。AS模型组和AS+ACI模型组大鼠脑组织可见vWF中等强度阳性、血管可见强阳性和非常强阳性表达,药物干预后比较,益脑康预防组和立普妥治疗组脑组织未见明显vWF表达,而益脑康治疗组为vWF弱阳性表达。在三个干预组血管中均表现为vWF中等强度阳性表达。AS造模组和ACI造模组大鼠脑组织可见TM中等强度阳性表达,在AS模型组和AS+ACI模型组大鼠脑组织未见TM阳性表达,益脑康预防组脑组织仍未见TM阳性表达,而益脑康治疗组和立普妥治疗组脑组织观测到TM弱阳性表达。
结论
益脑康胶囊预防或治疗性用药能够提高血清NO水平及增强TM表达,降低VEGF、PDGF-BB含量和减弱vWF表达,降低脑水肿,可以减轻血管内皮损伤、纠正内皮功能紊乱、延缓动脉粥样硬化和抗血栓形成,可能对于动脉粥样硬化和急性缺血中风具有防治作用。
Clinical Research
Objective
To evaluate the effect of integrated TCM therapy on ischemic stroke w ith/without hypertension patients'neural function deficits, levels of di sabilities, viabilities, qualities of lives and symptoms of Traditional C hinese Medicine and to evaluate the effect of hypertension on the efficac y of intervention in ischemic stroke with integrated TCM therapeutic prot ocol.
Methods
By analyzing the database information of the Tenth Five-Year Project Late Stage (named evaluation of acute ischemic stoke RCT clinical trial p rotocol), it is compared integrated TCM therapy protocol with Western con trol protocol, two different therapies treating ischemic stroke with/with out hypertension patients, from the aspects of NIHSS, mRS, BI, GOS, SS-QO L and SSTCM, to comprehensively evaluate the effect of integrated TCM the rapy protocol intervening the patients mentioned above.
By comparing differences of various levels'scale score between hyper tensive and non-hypertensive ischemic stroke treated with integrated TCM therapy, it is assessed the effect of hypertension factors on the prognos is of diseases and the efficacy of intervention protocol.
Results
For ischemic stroke patients with hypertension, integrated TCM therap y compared with western control treatment after diabetes history factors controlled. It is found that there are no significant differences between the two groups in NIHSS, BI, SSQOL (P>0.05); whereas there are significa nt differences in mRS, GOS, SSTCM between the two groups (P<0.05;P<0.01). The two groups in the 60th day's mRS, GOS, the 7th,60th day's SSTCM there are significant differences (P<0.05).
For ischemic stroke patients without hypertension, integrated TCM the rapy compared with western control treatment. It is found that there are no significant differences between the two groups in NIHSS, GOS, BI, SSQO L and SSTCM (P>0.05); whereas there is significant difference in mRS betw een the two groups (P<0.05). Between the two groups in the 60th,90th days' mRS, the 21st,60th,90th days'GOS, the 90th day's SSQOL and the 60th,90th days'SSTCM there are significant differences (P<0.05).
After histories of stroke and high cholesterol controlled, patients r eceiving integrated TCM therapy, their mRS, GOS change (P<0.05), but not their NIHSS, BI, SSQOL and SSTCM change (P>0.05), were influenced by fact ors of hypertension.
Conclusions
Integrated TCM protocol can effectively reduce ischemic stroke patien ts with hypertension the 60th day's disability level, to improve the 7th an d 60th day's clinical symptoms; reduce the ischemic stroke patients withou t hypertension the 21th,60th,90th days'levels of disabilities, to improve the 90th day's quality of life and the 60th,90th days'clinical symptoms of TCM. Treated by integrated TCM therapy, ischemic stroke patients'leve ls of disabilities were affected by factors of hypertension. Integrated T CM therapy has better efficacy to reduce non-hypertensive ischemic stroke patients'levels of disabilities.
Animals Study
Objective
By observing changes of concerning indicators, involving praxiology, pathology, biochemistry and histology, after Yinaokang capsule intervenin g atherosclerotic acute cerebral ischemic rats, the effect of preventing and treating atherosclerotic acute ischemic stroke is objectively evaluat ed.
Methods
By observing atherosclerosis and endothelial injury relative factors, i.e. NO, VEGF, PDGF-BB, vWF and TM, which are in the bloods and tissues of atherosclerotic acute cerebral ischemic rats intervened by Yinaokang c apsule, it is investigated Yinaokang capsule's potential mechanism about preventing and curing ischemic stroke.
Results
Yinaokang prevention group, Yinaokang treatment group and Lipitor tre atment group comparing with AS+ACI model group, brain water content decre ased and there were significant difference (P<0.05). Yinaokang prevention group, Lipitor treatment group comparing with AS+ACI model group, serum NO level increased and there were significant difference (P<0.05). Yinao kang treatment group comparing with AS+ACI model group, there was no sign ificant differences on NO levels(P>0.05); Yinaokang prevention group an d Lipitor treatment group, there was no significant differences on NO lev els (P>0.05). The three intervention group comparing with AS+ACI model g roup, serum VEGF, PDGF-BB level decreased and there were significant diff erence (P<0.01, P<0.05); between the three intervention group, there wa s no significant difference (P>0.05). In AS model group and AS+ACI model group, it was visible that vWF was moderately expressed in the brain tis sues, strongly and very strongly expressed in the blood vessels. Compared after medicines intervention, in the brain tissues there was no signific ant vWF expression in Yinaokang prevention group and Lipitor treatment gr oup, but in Yinaokang treatment group vWF was weakly expressed. In the th ree intervention groups, it were showed moderate vWF expression in blood vessels. In the AS modeling group and AS+ACI modeling group, moderate TM expression could be seen in the brain tissues. In the AS model group and AS+ACI model group, there were no TM expression in the brain tissues; TM expression was not seen in Yinaokang prevention group yet. While in Yinao kang treatment group and Lipitor treatment group, TM weak expression was observed in the brain tissues.
Conclusions
After atherosclerotic acute cerebral ischemic rats intervened by Yina okang capsule, their NO levels in the serum could be increased and vWF's expression in the tissues could be enhanced, their VEGF, PDGF-BB content in the serum could be decreased and TM' expression in the tissues could b e weakened. Cerebral edema was reduced as well. It can alleviate vascular endothelial injury, mend endothelial dysfunction and inhibit atheroscler osis as well as thrombosis. Hence, for Yinaokang capsule, there is preven tional and curative function in treating atherosclerotic acute cerebral i schemia in rats.
目的
评估中医综合治疗对合并高血压与非合并高血压的急性缺血中风患者神经功能缺损程度、残障水平、生活能力、生存质量和中医症候的影响以及高血压对中医综合方案干预缺血中风疗效的影响。
内容与方法
通过分析“十五”课题后期“急性缺血中风疗效评价RCT临床试验方案”数据库资料,比较中医综合疗法与西医常规治疗不同干预对合并高血压急性缺血中风患者在不同时点NIHSS评分、mRS评分、BI指数、GOS评分、SS-QOL积分、中医症征积分的影响,以期全面评价中医综合方案对高血压性及非高血压性急性缺血中风疾病的干预作用。通过比较有高血压与无高血压缺血中风患者分别接受中医综合治疗后各水平量表评分上的差异,以评估高血压因素对疾病预后及干预方案疗效的影响。
结果
对于合并高血压的缺血中风患者,控制糖尿病史因素,中医综合治疗与西医对照治疗比较,患者在NIHSS、BI、SSQOL上两组之间差异无统计学意义(P>0.05)；在mRS、GOS、SSTCM上两组之间差异有统计学意义(P<0.05；P<0.01)。两组在第60天mRS、GOS,第0天、7天、60天SSTCM上差异有统计学意义(P<0.05)。
对于非合并高血压的缺血中风患者,中医综合治疗与西医对照治疗比较,患者在NIHSS、GOS、BI、SSQOL、SSTCM上两组之间差异无统计学意义(P>0.05)。在mRS上两组之间差异有统计学意义(P<0.05)。两组在第60天、90天mRS,第21天、60天、90天GOS,第90天SSQOL,第60天、90天SSTCM上差异有统计学意义(P<0.05)。
在控制脑卒中史、高胆固醇史,高血压因素对中医综合治疗后患者的NIHSS、BI、SSQOL、SSTCM改变无影响(P>0.05)；对中医综合治疗后患者的mRS、GOS改变有影响(P<0.05)。
结论
中医综合治疗方案能有效减轻合并高血压的缺血中风患者第60天残障水平,改善第7天、第60天中医症状；降低非合并高血压缺血中风患者第21天、60天、90天残障水平,提高第90天生存质量,改善60天、90天中医症状；高血压因素对中医综合治疗缺血中风患者的残障水平有影响,中医综合治疗对降低非高血压性缺血中风患者残障水平疗效更好。
实验部分
目的
通过观察益脑康胶囊干预对动脉粥样硬化性急性缺血中风大鼠行为学、病理学、生化学、组织学相关指标的改变,以客观评价中药益脑康胶囊对动脉粥样硬化性急性缺血中风的防治作用。
内容与方法
观察中药益脑康胶囊对动脉粥样硬化性急性缺血中风大鼠血液及组织中N0、VEGF、PDGF-BB、vWF、TM等动脉硬化及内皮损伤相关因子的影响,以探讨益脑康胶囊发挥缺血中风防治作用的可能机制。
结果
益脑康预防组、益脑康治疗组、立普妥治疗组大鼠脑组织含水量低于AS+ACI模型组,差异有显著统计学意义(P<0.01)。益脑康预防组、立普妥治疗组与AS+ACI模型组比较,血清NO水平增高,差异有统计学意义(P<0.01,P<0.05)；益脑康治疗组与AS+ACI模型组比较,NO水平差异无统计学意义(P>0.05)；益脑康预防组与立普妥治疗组比较,NO水平差异无统计学意义(P>0.05)。三个干预组与AS+ACI模型组比较,血清VEGF、PDGF-BB水平下降,差异有统计学意义(P<0.01,P<0.05)；三个干预组之间比较,血清VEGF、PDGF-BB水平差异无统计学意义(P>0.05)。AS模型组和AS+ACI模型组大鼠脑组织可见vWF中等强度阳性、血管可见强阳性和非常强阳性表达,药物干预后比较,益脑康预防组和立普妥治疗组脑组织未见明显vWF表达,而益脑康治疗组为vWF弱阳性表达。在三个干预组血管中均表现为vWF中等强度阳性表达。AS造模组和ACI造模组大鼠脑组织可见TM中等强度阳性表达,在AS模型组和AS+ACI模型组大鼠脑组织未见TM阳性表达,益脑康预防组脑组织仍未见TM阳性表达,而益脑康治疗组和立普妥治疗组脑组织观测到TM弱阳性表达。
结论
益脑康胶囊预防或治疗性用药能够提高血清NO水平及增强TM表达,降低VEGF、PDGF-BB含量和减弱vWF表达,降低脑水肿,可以减轻血管内皮损伤、纠正内皮功能紊乱、延缓动脉粥样硬化和抗血栓形成,可能对于动脉粥样硬化和急性缺血中风具有防治作用。
Clinical Research
Objective
To evaluate the effect of integrated TCM therapy on ischemic stroke w ith/without hypertension patients'neural function deficits, levels of di sabilities, viabilities, qualities of lives and symptoms of Traditional C hinese Medicine and to evaluate the effect of hypertension on the efficac y of intervention in ischemic stroke with integrated TCM therapeutic prot ocol.
Methods
By analyzing the database information of the Tenth Five-Year Project Late Stage (named evaluation of acute ischemic stoke RCT clinical trial p rotocol), it is compared integrated TCM therapy protocol with Western con trol protocol, two different therapies treating ischemic stroke with/with out hypertension patients, from the aspects of NIHSS, mRS, BI, GOS, SS-QO L and SSTCM, to comprehensively evaluate the effect of integrated TCM the rapy protocol intervening the patients mentioned above.
By comparing differences of various levels'scale score between hyper tensive and non-hypertensive ischemic stroke treated with integrated TCM therapy, it is assessed the effect of hypertension factors on the prognos is of diseases and the efficacy of intervention protocol.
Results
For ischemic stroke patients with hypertension, integrated TCM therap y compared with western control treatment after diabetes history factors controlled. It is found that there are no significant differences between the two groups in NIHSS, BI, SSQOL (P>0.05); whereas there are significa nt differences in mRS, GOS, SSTCM between the two groups (P<0.05;P<0.01). The two groups in the 60th day's mRS, GOS, the 7th,60th day's SSTCM there are significant differences (P<0.05).
For ischemic stroke patients without hypertension, integrated TCM the rapy compared with western control treatment. It is found that there are no significant differences between the two groups in NIHSS, GOS, BI, SSQO L and SSTCM (P>0.05); whereas there is significant difference in mRS betw een the two groups (P<0.05). Between the two groups in the 60th,90th days' mRS, the 21st,60th,90th days'GOS, the 90th day's SSQOL and the 60th,90th days'SSTCM there are significant differences (P<0.05).
After histories of stroke and high cholesterol controlled, patients r eceiving integrated TCM therapy, their mRS, GOS change (P<0.05), but not their NIHSS, BI, SSQOL and SSTCM change (P>0.05), were influenced by fact ors of hypertension.
Conclusions
Integrated TCM protocol can effectively reduce ischemic stroke patien ts with hypertension the 60th day's disability level, to improve the 7th an d 60th day's clinical symptoms; reduce the ischemic stroke patients withou t hypertension the 21th,60th,90th days'levels of disabilities, to improve the 90th day's quality of life and the 60th,90th days'clinical symptoms of TCM. Treated by integrated TCM therapy, ischemic stroke patients'leve ls of disabilities were affected by factors of hypertension. Integrated T CM therapy has better efficacy to reduce non-hypertensive ischemic stroke patients'levels of disabilities.
Animals Study
Objective
By observing changes of concerning indicators, involving praxiology, pathology, biochemistry and histology, after Yinaokang capsule intervenin g atherosclerotic acute cerebral ischemic rats, the effect of preventing and treating atherosclerotic acute ischemic stroke is objectively evaluat ed.
Methods
By observing atherosclerosis and endothelial injury relative factors, i.e. NO, VEGF, PDGF-BB, vWF and TM, which are in the bloods and tissues of atherosclerotic acute cerebral ischemic rats intervened by Yinaokang c apsule, it is investigated Yinaokang capsule's potential mechanism about preventing and curing ischemic stroke.
Results
Yinaokang prevention group, Yinaokang treatment group and Lipitor tre atment group comparing with AS+ACI model group, brain water content decre ased and there were significant difference (P<0.05). Yinaokang prevention group, Lipitor treatment group comparing with AS+ACI model group, serum NO level increased and there were significant difference (P<0.05). Yinao kang treatment group comparing with AS+ACI model group, there was no sign ificant differences on NO levels(P>0.05); Yinaokang prevention group an d Lipitor treatment group, there was no significant differences on NO lev els (P>0.05). The three intervention group comparing with AS+ACI model g roup, serum VEGF, PDGF-BB level decreased and there were significant diff erence (P<0.01, P<0.05); between the three intervention group, there wa s no significant difference (P>0.05). In AS model group and AS+ACI model group, it was visible that vWF was moderately expressed in the brain tis sues, strongly and very strongly expressed in the blood vessels. Compared after medicines intervention, in the brain tissues there was no signific ant vWF expression in Yinaokang prevention group and Lipitor treatment gr oup, but in Yinaokang treatment group vWF was weakly expressed. In the th ree intervention groups, it were showed moderate vWF expression in blood vessels. In the AS modeling group and AS+ACI modeling group, moderate TM expression could be seen in the brain tissues. In the AS model group and AS+ACI model group, there were no TM expression in the brain tissues; TM expression was not seen in Yinaokang prevention group yet. While in Yinao kang treatment group and Lipitor treatment group, TM weak expression was observed in the brain tissues.
Conclusions
After atherosclerotic acute cerebral ischemic rats intervened by Yina okang capsule, their NO levels in the serum could be increased and vWF's expression in the tissues could be enhanced, their VEGF, PDGF-BB content in the serum could be decreased and TM' expression in the tissues could b e weakened. Cerebral edema was reduced as well. It can alleviate vascular endothelial injury, mend endothelial dysfunction and inhibit atheroscler osis as well as thrombosis. Hence, for Yinaokang capsule, there is preven tional and curative function in treating atherosclerotic acute cerebral i schemia in rats.
引文
[1]张伯礼,王玉来,高颖,等.中风病急性期综合治疗方案研究与评价—附522例临床研究报告[J].中国危重病急救医学,2005,17(5)：259-263.
[2]任继学,任玺洁,王中男,等.中风病急性期的中医药辨证治疗——附1637例临床观察[J].中风中医急症,1995,4(2)：63-64.
[3]王永炎,孙塑伦,邓振明,等.辨证论治加复方活血注射液治疗中风急症的临床研究[J].北京中医学院学报,1988,11(1)：22-24.
[4]蔡业峰,付于,郭建文,等.中医药治疗急性缺血中风的多中心随机对照研究[J].中药材,2007,30(9)：1192-1195.
[5]蔡业峰,付于,郭建文,等.中医综合治疗方案对急性缺血性中风中医症征影响的研究[J].陕西中医,2007,28(8)：1037-1041.
[6]刘晓俊,高敏,黄汉超,等.中医综合疗法干预急性缺血性中风对BI指数和(GOS)评分的影响[J].中药材,2008,31(5)：800-803.
[7]刘晓俊,高敏,黄汉超,等.中医综合疗法干预急性缺血性中风疗效观察[J].中国中医药信息杂志,2008,15(7)：73-74.
[8]刘晓俊,高敏,陈景亮,等.中医综合疗法干预急性缺血性中风对RANKIN及SS—QOL量表的影响[J].中国实用医药,2008,3(22)：4-6.
[9]许萌.灯盏细辛注射液配中医辨证治疗缺血性脑卒中108例[J].陕西中医,2006,27(11)：1042-1043.
[10]韩艳秋,贺启俊.中西医结合综合治疗脑卒中先兆临床观察[J].辽宁中医杂志,2006,33(4)：456.
[11]何劲.中药多途径辅助治疗对脑卒中急性期疾病转归的影响[J].中国中西医结合杂志,2002,22(4)：314.
[12]高颖,王永炎.从循证医学角度谈中医药防治脑卒中的研究[J].中国临床康复,2003,7(1)：56-57.
[13]Duncan PW, Jorgensen HS, Wade DT. Outcome measures in acute stroke t rials:a systematic review and some recommendations to improve practice[J]. stroke.,2000,31:1429-1438.
[14]Granger CV, Hamilton BB, Gresham GE. The stroke rehabilitation outco me study-Part Ⅰ:general description[J]. Arch Phys Med Rehabil.1988,69: 506-509.
[15]Korner-Bitensky N, Wood-Dauphinee S. Barthel Index information elici ted over the telephone:is it reliable? [J].Phys Med Rehabil.1995,74:9-1 8.
[16]Lees KR, Zivin JA, Ashwood T, et al. NXY-059 for acute ischemic stro ke [J]. N Engl,2006,354:588-600.
[17]Fitzpatrick R, Davey C, Buxton MJ, et al. Evaluating patient-based o utcome measures for use in clinical trials [J]. Health Technology Assessm ent.1998,14 (2):235-238.
[18]Hantson L, Deweerdt W, Dekeyser J, et al. The european stroke Scale [J]. Stroke,1994,25:2215-2219.
[19]王伊龙,马建国,李军涛,等.脑卒中生存质量量表中译本信度和效度及敏感度的初步研究[J].中华老年心脑血管病杂志.2003,5(6)：391-394.
[20]Hilari K, Byng S, Lamping D L. Stroke and aphasia quality of life sc ale-39 (SA QOL-39):Evaluation of acceptability, reliability, and validi ty[J]. Stroke,2003,34(8):1944-1950.
[21]赖世隆.中医药临床疗效评价若干关键环节的思考[J].广州中医药大学学报,2002,19(4)：245-250.
[22]赖世隆,郭新峰,梁伟雄,等.中风病临床疗效评价指标体系的初步研究.中国中西医结合杂[J],2004,24(3)：197-201.
[23]招远祺,文龙龙,蔡业峰,等.中风中医症征积分表多中心测评[J].河南中医,2008,28(7)：38-40.
[24]胡学军,商洪才,张伯礼,等.生存质量及其量表在中医药疗效评价中的应用[J].天津中医药,2004,21(3)：191：191-193.
[25]王维治.神经病学[M].北京：人民卫生出版社,2005,(第5版)：130.
[26]陈主初.病理生理学[M].北京：人民卫生出版社,2006,(第1版)：285-286.
[27]Van Gieson EJ, Murfee WL, Skalak TC, et al. Enhanced smooth muscle ce 11 coverage of microvessels exposed to increased hemodynamic stresses in vivo[J]. Circ Res,2003,9(8):929-936.
[28]全世界对动脉粥样硬化血栓性疾病(AS)的流行情况、认识水平与治疗(JAMA,2006,295：184-189).高血压杂志,2006,14(4)：327.
[29]Sacco RL, Ellenberg JH, Mobr JP, et al. Infarcts of undetermined caus e:the NINCDS Stroke Data Ban k. Aan Neurol,1989,25:382-390.
[30]Salcuni M, Di Lazzaro V, Di Stasi C, et al. The role of Doppler US i n the study of carotid system[J]. Rays,1995,20(40):406-25.
[31]Polak JF,O'Leary DH, Kronmal RA, et al. Sonographic evaluation of c arotid artery atherosclerosis in the elderly:relationship of disease sev erity to stroke and transient ischemic attack[J]. Radiology,1993,188(2): 363-70.
[32]王拥军.应加强颈动脉粥样硬化的基础和临床研究[J].中华神经科学杂志,2001,34(5)：257-258.
[33]丁建平,华扬,王拥军,等.急性缺血性脑血管病患者脑动脉粥样硬化的分布[J].中华医学影像技术,2001,17(1)：29-31.
[34]章成国,张虹桥,谢坚,等.缺血性脑血管病与颈动脉粥样硬化的关系[J].中华神经病学杂志,2006,39(2)：832-835.
[35]曾桄伦,邵燕,章成国.颈动脉粥样硬化与脑梗死复发的关系[J].临床神经病学杂志,2005,18(1)：61-61.
[36]陈主初.病理生理学.北京：人民卫生出版社,2006,(第1版)：170-171.
[37]Durand E, Seoagee A, Lafont A, et al. In vivo induction of endotheli al apoptosis leads to vessel thrombosis and endothelial denudation:a clu e to the undemtanding of the mechanisms of thrombotic plaque erosion[J]. Circulation,2004,109:2503-2506.
[38]Esposito K, Marfalla R, Ciotola M, et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammatio n in the metabolic syndrome:a randomized trial[J]. JAMA,2004,292(12):14 40-1446.
[39]Lip GY, Blann A. von Willebrand factor:a marker of endothelial dysfun ction in vascular disorders[J]? Cardiovasc Res,1997,34:255-265.
[40]Spencer CGC, Gumey D, Blann AD, et al. Van willebrand factor, solubl e P-selectin, and target organ damage in hypertension:A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial[J]. Hypertension,2002,40:61-66.
[41]汪艳,任明山.脑梗死患者血液vWF和VEGF含量的动态变化及临床意义[J].临床输血与检验,2008,10(3)：215-217.
[42]周有利,付萍,毛达勇,等.CD62p、CD63和vWF在脑梗死患者中的临床意义[J].国际检验医学杂志,2007,28(8)：766、768.
[43]刘靖,杨靓,孙宁玲,等.微量白蛋白尿及假性血友病因子与高血压代谢综合征的关系[J].北京大学学报(医学版),2007,39(6)：587-590.
[44]纪求尚,张运,郭媛媛,等.急性心肌梗死患者促凝因子的动态变化及意义[J].山东大学学报(医学版),2004(42)3：284-286.
[45]Inoue M, Itoh H, Veda M, et al. Vascular endothelial growth factor (VEGF) expression in human coronary atherosclerotic lesions[J]. circulati on,1998,98(20):2108-2116.
[46]Tenaglia AN, Peters KG, Sketch MH, et al. Neovascularization in athe rectomy specimens in patients with unstable angina[J]. Am Heart,1998, (1) 135:10-14.
[47]Leek RD, Hunt NC, Landers RJ, et al. Macrophage infiltration is asso ciated with VEGF and EGFR expression in breast cancer[J]. J Pathol,2000, 190(4):430-436.
[48]朱其秀,卢瑞春,谭兰,等.颈动脉粥样硬化狭窄患者血管内皮生长因子检测及意义.中风与神经疾病杂志[J],2007,24(5)：596-597.
[49]关德明.动脉粥样硬化形成机制研究进展[J].哈尔滨医科大学学报,1999,33(6)：502-504.
[50]吕琳,鹿克凤,罗静等.氟伐他汀对兔动脉粥样硬化血管壁NF-κB和PDGF表达的影响[J].临床心血管病杂志,2005,21(8)：478-481.
[51]Ohara Y, Peterson T E, Sayegh H S, et al. Dietary correction of hype rcholesteralemia in the rabbit normalizes endothelial superoxide amon pro duction[J]. Circulation,1995,92:898-903.
[52]Valeric B1, Bruce A. Interactions between nitre oxide and lipid oxid ation pathways[J]. Cric Res,2001,88:12-21.
[53]卢兴国,童杰峰,张强,等.血浆凝血酶调节蛋白检测的临床应用[J].中国病理生理杂志,2007,23(7)：1451-1453.
[54]Giesen PL, RauehU, Bohrmarm B, et al. Blood-borne tissue factor:ano ther view of thrombosis[J]. Proc Nail Aead.Sci USA,1999,96:2311-2315.
[55]卢兴国,潘智勇,赵小英,等.心脑血管病和糖尿病相互合并与血浆凝血酶调节蛋白水平的变化[J].微循环技术杂志：临床与实验,2004,8(5)：348-349.
[56]奕泉根,卢兴国,朱蕾,等.血浆凝血酶调节蛋白在评估血管病变和并发症中的意义[J].中国微循环,2005,9(6)：417-419.
[57]王朝晖,龚平,杜林林,等.动脉粥样硬化并发血栓形成家兔模型的研究[J].中国病理生理杂志,2006,22(10)：2071-2073.
[58]高奋,李静梅,肖传实,等.高同型半胱氨酸血症兔模型动脉粥样硬化的形成[J].中国动脉硬化杂志.2002,10(4)：348.
[59]刘录山,杨永宗,冯大明,等.小型猪动脉粥样硬化斑块稳定性模型研究[J].生物化学与生物物理进展,2006,33(2)：196-200.
[60]Shi XY. Modem medicine animal experiment[M]. Bei jing:People S Mili tary Medicine Press,2000:470-472.
[61]马杰,郭力辉,张秀敏,等.鹌鹁动脉粥样硬化模型的探讨[J].动物学杂志,1997,32(2)：19-21.
[62]Reddick RL, Zhang SH, Maeda N. Aortic atheroscleroticplaque injury i n apolipoprotein E deficient mice[J]. Atherosclerosis 1998:140(2):297-3 05.
[63]Rekhter MD, shah N, Simari RD, et al. Animal model thatmimics athero sclerotic plaque rupture[J]. Circ Res 1998; 83(7):705-713.
[64]Joen RS, Ching HW. Mechanisms in the inhibition of neointimal hyperp lasis with triflavin in a rat model of balloon angioplast3[J]. J Lab Clin Med,2001,13(4):270.
[65]仲琳,张运,张梅,等.兔动脉粥样硬化易损斑块模型的建立[J].基础医学与临床,2005,25(4)：370-373.
[66]姜炜,郭阳.颈动脉内膜切除术后再狭窄动物模型的建立[J].天津医药,2007,2(35)：2.
[67]吴开云,高摄渊,袁融,等.维生素D3诱发大鼠动脉粥样硬化的实验研究[J].解剖学报,1996,27(2)：133-135
[68]沈丽,卢维晟,姚俊宇,等.不同方法建立动诛粥样硬化大鼠模型的比较[J].心脏杂志,2005,17(1)：18-20.
[69]温进坤,韩梅,杜玮南,等.一种快速建立大鼠动脉粥样硬化模型的实验方法[J].中国老年病学杂志,2001,21：50-52.
[70]Bujan J, Be Lloa JM, Sabater C, et al. Modifications induced by athe rogenie diet in the capacity of the arterial wall in rats to respond to s urgical insult[J]. Atherosclerosis,1996:122:141.
[71]郭延松,吴宗贵.鼠动脉粥样硬化模型复制方法的比较[J].中国动脉硬化杂志。2003,11(5)：465.
[72]杨鹏远,芮耀诚,焦亚斌,等.动脉粥样硬化大鼠实验模型的建立[J].第二军医大学学报,2003,24(7)：802-804.
[73]李秋梅,王硕仁,赵明镜.家兔新型动脉粥样硬化狭窄模型的建立及其动态观察[J].中国实验动物学报,2004,12(1)：26-28.
[74]Zhang SH, Reddick RL, Piedrahita JA et al. Spontaneous hypercholeste rolemia and arterial lesions in mice lacking apolipo protein E[J]. Scienc e 1992:258(5081):468-471.
[75]Traystman RJ. Animal models of focal and global cerebral ischemia[J]. ILAR,2003,44(2):85-95.
[76]Wang cx, rang Y, Yang T, et al. A focal embolic model of cerebral is chemia in rats:introduction and evaluation[J]. Brain Res Protoc.2001,7 (2):115-20.
[77]Krueger K, Busch E. Protocol of a thromboembolic stroke model in the rat:review of the experimental procedure and comparison of models[J]. In vest Radiol,2002,37(11):600-8.
[78]Sekiguehi M, Takagi K, Takagi N, et al. Time course and sequence of pathological changes in the cerebellum of microsphere embolized rats[J]. Exp Neurol,2005, (191):266-27.
[79]Ginsberg MD, Busto R. Rodent models of cerebral isehemia[J]. Stroke, 1989,20 (12):627-642.
[80]Sharkey J, Ritchie IM, Kelly PA. Perivascular microapplication of en dothelin-1:a new model of focal cerebral ischaemia in the rat[J]. J Cereb Blood Flow Metab,1993,13:865-821.
[81]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1)：55-56.
[82]中华医学会神经科学会.各类脑血管疾病的诊断要点[J].中华神经科杂志,1996,29(6)：379.
[83]Bamford J, Dennis M, Sandercock P, et al. The frequency, causes and timing of death within 30 days of acute stroke:the Oxfordshire Community Stroke Project (OCSP) [J]. J Neurology Neurosurg Psychiatry 1990:53:82 4-29.
[84]蔡业峰,付于,郭建文,等.中医药治疗急性缺血中风的多中心随机对照研究[J].中药材,2007,30(9)：1192-1195.
[85]蔡业峰,贾真,李伟峰,等.中文版Barthel指数对多中心测评缺血性卒中患者预后的研究[J].中国脑血管病杂志,2007,4(11)：486-490.
[86]Song F, Jerosch-Herold C, Holland R, et al, Statistical methods for a nalysing Barthel scores intrials of poststroke interventions:a review and computer simulations[J]. Clin Rehabil,2006,20:347-356.
[87]饶明俐.中国脑血管病指南[M].北京：人民卫生出版社,2007,(第1版)：2.
[88]Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community:is the "rule of halves" still valid [J]? J Hum Hypertens,1997,11:213-220.
[89]Basile JN, Bloch MJ. Identifying and managing factors that interfere with or worsen blood pressure contro[J]. Postgrad Med,2010,122(2):35-4 8.
[90]王增武,曹鲁琴,武阳丰,等.医疗卫生人员脑卒中相关知识、态度及行为水平的调查.中华内科杂志,2001,40：296-298.
[91]Rodriguez-Yanez M, Castellanos M, Blanco M, et al. New-onset hyperten sion and inflammatory response/poor outcome in acute ischemic stroke[J]. Neurology,2006,67(11):1973-8.
[92]High blood pressure and inflammation are associated with poor progno sis in lacunar infarctions. Cerebrovasc Dis,2006,22(2-3):123-9.
[93]丁国峰,毛艳华,石斗飞,等.老年高血压并缺血性脑卒中患者血浆同型半胱氨酸变化的临床意义[J].山东医药,2006,46(1)：30-31.
[94]陈东骊,莫与京,陈富荣,等.原发性高血压合并缺血性脑卒中与非对称性二甲基精氨酸及高敏C反应蛋白的相关性[J].广东医学,2008,29(5)：769-771.
[95]王少杰,袁晓梅,严东辉,等.中药醒脑静治疗自发性高血压脑卒中大鼠实验观察[J].中医杂志,1998,39(5)：303-304.
[96]钟广伟,李炜,陈民敬,等.天麻、钩藤、石决明、牡蛎、牛膝混合剂对高血压大鼠血管重构的影响[J].中华高血压杂志,2008,16(9)：812-816.
[97]余昭锐,王苓潇,陈燕.天麻素注射液治疗急性缺血性脑卒中的疗效观察[J].中国中西医结合杂志,2007,27(4)：377-378.
[98]顾天华,钱岳晟,张照英,等.黄芪与川芎在治疗自发性高血压大鼠中的相互作用研究[J].中国中西医结合杂志,2002,S1期.
[99]王亚玲,崔张新,李方红.丹参与川芎联合用药对冠心病患者脂代谢及血液流变性的影响[J].时珍国医国药,2009,20(9)：2169-2170.
[100]李可建.川芎嗪注射液治疗缺血性中风急性期随机对照实验的系统评价[J].时珍国医国药,2006,17(10)：1874-1876.
[101]陈治奎,胡申江,夏强,等.黄芪对自发性高血压大鼠的抗高血压效应及其机制的初步研究[J].中国实验诊断学,2008,12(6)：705-710.
[102]阮耀,黄川锋,岳兴如.黄芪预处理对大鼠脑缺血再灌注损伤的保护作用.时珍国医国药,2009,20(1)：103-104.
[103]郑峰,褚剑锋,熊尚全,等.灯盏细辛注射液治疗瘀证型高血压病的临床观察[J].广东医学,2007,28(2)：306-307.
[104]李娜,姜义,孙海欣,等.灯盏细辛注射液治疗急性脑梗死有效性的临床研究[J].首都医科大学学报,2008,29(3)：336-339.
[105]蔡业峰,张新春,郭建文,等.灯盏细辛注射液治疗缺血性中风急性期随机对照试验的Meta分析[J].广东医学,2007,28(8)：1335-1337.
[106]金明华,丘瑞香.华佗再造丸对缺血性中风患者血液流变性,SOD/MDA及NO调节的影响[J].中药材,1999,22(8)：427-428.
[107]刘金刚,李忠文,徐红梅,等.华佗再造丸抗血栓作用及对实验性微循环障碍的影响[J].广东医学,2000,21(5)：368-370.
[108]沈丽,卢维晟,姚俊宇,等.不同方法建立动脉粥样硬化大鼠模型比较[J].心脏杂志,2005,10(1)：18-20.
[109]顾国军,黄振兴,陶凯忠,等.HBO-1对内皮素-1诱导的大鼠局灶性脑缺血模型的疗效观察[J].第二军医大学学报,2006,27(10)：1134-1137.
[110]Zea Longa E1, W einstein PR, Carlson S, et a. Reversible middle cer ebral artery occlusion without craniectomy in rat [J]. Stroke,1989,20: 84-91.
[111]许良中,杨文涛.免疫组织化学反应结果的判断标准.中国癌症杂志,1996,6(4)：229-230.
[112]Blanco M, Rodriguez-Yanez M, Sobrino T, et al. Platelets, inflammat ion, and atherothrombotic neurovascular disease:the role of endothelial dysfunction. Cerebrovasc Dis.2005,20 (2):32-9.
[113]温绍君,叶平,李家增.动脉粥样硬化与易损斑块[J].中华内科杂志,2006,45(3)：259-260.
[114]陈小明.一氧化氮和心血管疾病(待续)[J].中华高血压杂志,2008,16(9)：847-848.
[115]陈小明.一氧化氮和心血管疾病(续二)[J].中华高血压杂志,2008,16(11)：1041-4042.
[116]Viswambhara H, Carvas JM, Antic V, et al. Mutation of the Circadian Clock Gene Per2 Alters Vascular Endothelial Function[J]. Circulation,20 07,115:2188.
[117]Vercauteren M, Remy E, Devaux C, et al. Improvement of Peripheral E ndothelial Dysfunction by Protein Tyrosine Phosphatase Inhibitors in Hear t Failure[J]. Circulation,2006,114:2498.
[118]Forstermann U, Mugge A, Alheid U, et al. Selective attenuation of e ndothelium-mediated vasodilation in atherosclerotic human coronary arteri es[J]. Circ. Res.,1988,62,185-190.
[119]Hirata Y, Nagata D, Suzuki E, et al. Diagnosis and treatment of end othelial dysfunction in cardiovascular disease[J]. Int Heart J,2010,51 (1):1-6.
[120]Pang J, Xu Q, Xu X, et al. Hexarelin suppresses high lipid diet and vitamin D3-induced atherosclerosis in the rat[J]. Peptides,2010,31(4): 630-8.
[121]Ruggeri, Z. M. Platelets in atherothrombosis[J]. Nat. Med,2002,8: 1227-1234.
[122]Dvorak HF, Brown LF, Detar M, et al. Vascular permeabi 1 ity factor /vascular endothel ial growth factor, microvascular, hyperpermeability, and angiogenesis [J]. Am J Pathol,1995,146(5):1029.
[123]赵仙先,朱家麟.血管内皮生长因子在动脉粥样硬化斑块中的表达[J].第二军医大学学报,1999,20(9)：669-671.
[124]李健芝,常青,唐海兰,等.丙二醛、ET—1、VEGF在动脉粥样硬化形成过程中的动态变化.解剖学杂志,2003,26(1)：7-11.
[125]张克俭,刘煜敏,张丽,等.PAI-1、u-PA、VEGF、CD34在动脉粥样硬化鼠急性脑缺血中的表达及意义[J].武汉大学学报：医学版,2007,28(6)：711-714.
[126]陈建华,刘晓娟,曾鸿,等.脑出血与脑梗死患者血清VEGF水平动态变化的研究.中国现代医学杂志,2008,18(5)：602-604.
[127]刘亢丁,潘成利,宫萍,等.脑梗死患者急性期血清VEGF含量变化及临床意义.吉林大学学报：医学版,2003,29(3)：345-346.
[128]李静,陈可冀.血小板衍化生长因子(PDGF)与动脉粥样硬化[J].生命科学,1995,7(1)：5-10.
[129]Ross R, Bowen-Pope DF, Raines EW, et al. Platelet derived growth fa ctor and its role in health and disease [J]. Phlos Ttmas R Soc Lond [Bio 1],1990,327(1239):155-169.
[130]韩英,谢良地,许昌声,等.氟伐他汀对大鼠血管平滑肌细胞迁移的影响及其机制.中国病理生理杂志,2005,21(11)：2133-2136.
[131]谢良地,吴可贵,陈达光,等.血小板源生长因子诱导血管平滑肌细胞迁移及机制[J].中国动脉硬化杂志,1998,6(1)：10-14.
[132]Au P, Tam J, Duda DG, et al. Paradoxical effects of PDGF-BB overexp ression in end-othelial cells on engineered blood vessels in vivo[J]. Am J Pathol,2009,175(1):294-302.
[133]Briede JJ, Wielders SJ, Heemskerk JW, et al. Von Willebrand factor s timulates thrombin-induced exposure of procoagulant phospholipids on the surface of fibrin-adherent platelets[J]. J Thromb Haemost,2003,1(3): 559-565.
[134]Kohler HP, Grant PJ. Plasminogen activator inhibitor type 1 and coro nary artery disease[J]. N Engl J Med,2002,342:1792-1800.
[135]Vandewouwer M, Collen D, Conway EM. Thrombomdulin protein C-EPCR sys tem[J]. Biology,2004,24:1374-1385.
[136]张蕾,孙旦澄,张燕香.脑梗死和心肌梗死患者血栓调节蛋白的检测及临床应用[J].检验医学,2005,20(1)：40-41.
[137]Olivot JM, Labreuche J, Aiach M, et al. Soluble thrombomodulin and b rain infarction:case-control and prospective study[J]. Stroke,2004,35 (8):1946-1951.
[138]于逢春,翟艳苓,刘艳,等.急性脑梗死患者血浆组织因子及血栓调节蛋白的研究[J].北京医学,2006,28(4)：196-198.
[139]Yokota H. Cerebral endothelial damage after severe head injury[J]. N ippon Med Sch,2007,74(5):332-7.
[140]Nomura E, Kohriyama T, Kozuka K, et al. Significance of serum solub le thrombodulin level in acute cerebral infarction[J]. Eur Jneurol,2004, 11(5):329-334.
[141]Ariyarajah V, Dawe DE, Khadem A. Is there a role for statins in atr ial fibrillation [J]? Pacing Clin Electrophysiol,2009,32(8):1063-72.
[142]曲莉,刘宗武,赵学忠.他汀类药物多效性研究进展[J].中国老年学杂志,2010,30(2)：280-282.
[143]陈竺.全国第三次死因回顾抽样调查报告-中华人民共和国卫生部[R].北京：协和医科大学出版社,2008,10.
[2]任继学,任玺洁,王中男,等.中风病急性期的中医药辨证治疗——附1637例临床观察[J].中风中医急症,1995,4(2)：63-64.
[3]王永炎,孙塑伦,邓振明,等.辨证论治加复方活血注射液治疗中风急症的临床研究[J].北京中医学院学报,1988,11(1)：22-24.
[4]蔡业峰,付于,郭建文,等.中医药治疗急性缺血中风的多中心随机对照研究[J].中药材,2007,30(9)：1192-1195.
[5]蔡业峰,付于,郭建文,等.中医综合治疗方案对急性缺血性中风中医症征影响的研究[J].陕西中医,2007,28(8)：1037-1041.
[6]刘晓俊,高敏,黄汉超,等.中医综合疗法干预急性缺血性中风对BI指数和(GOS)评分的影响[J].中药材,2008,31(5)：800-803.
[7]刘晓俊,高敏,黄汉超,等.中医综合疗法干预急性缺血性中风疗效观察[J].中国中医药信息杂志,2008,15(7)：73-74.
[8]刘晓俊,高敏,陈景亮,等.中医综合疗法干预急性缺血性中风对RANKIN及SS—QOL量表的影响[J].中国实用医药,2008,3(22)：4-6.
[9]许萌.灯盏细辛注射液配中医辨证治疗缺血性脑卒中108例[J].陕西中医,2006,27(11)：1042-1043.
[10]韩艳秋,贺启俊.中西医结合综合治疗脑卒中先兆临床观察[J].辽宁中医杂志,2006,33(4)：456.
[11]何劲.中药多途径辅助治疗对脑卒中急性期疾病转归的影响[J].中国中西医结合杂志,2002,22(4)：314.
[12]高颖,王永炎.从循证医学角度谈中医药防治脑卒中的研究[J].中国临床康复,2003,7(1)：56-57.
[13]Duncan PW, Jorgensen HS, Wade DT. Outcome measures in acute stroke t rials:a systematic review and some recommendations to improve practice[J]. stroke.,2000,31:1429-1438.
[14]Granger CV, Hamilton BB, Gresham GE. The stroke rehabilitation outco me study-Part Ⅰ:general description[J]. Arch Phys Med Rehabil.1988,69: 506-509.
[15]Korner-Bitensky N, Wood-Dauphinee S. Barthel Index information elici ted over the telephone:is it reliable? [J].Phys Med Rehabil.1995,74:9-1 8.
[16]Lees KR, Zivin JA, Ashwood T, et al. NXY-059 for acute ischemic stro ke [J]. N Engl,2006,354:588-600.
[17]Fitzpatrick R, Davey C, Buxton MJ, et al. Evaluating patient-based o utcome measures for use in clinical trials [J]. Health Technology Assessm ent.1998,14 (2):235-238.
[18]Hantson L, Deweerdt W, Dekeyser J, et al. The european stroke Scale [J]. Stroke,1994,25:2215-2219.
[19]王伊龙,马建国,李军涛,等.脑卒中生存质量量表中译本信度和效度及敏感度的初步研究[J].中华老年心脑血管病杂志.2003,5(6)：391-394.
[20]Hilari K, Byng S, Lamping D L. Stroke and aphasia quality of life sc ale-39 (SA QOL-39):Evaluation of acceptability, reliability, and validi ty[J]. Stroke,2003,34(8):1944-1950.
[21]赖世隆.中医药临床疗效评价若干关键环节的思考[J].广州中医药大学学报,2002,19(4)：245-250.
[22]赖世隆,郭新峰,梁伟雄,等.中风病临床疗效评价指标体系的初步研究.中国中西医结合杂[J],2004,24(3)：197-201.
[23]招远祺,文龙龙,蔡业峰,等.中风中医症征积分表多中心测评[J].河南中医,2008,28(7)：38-40.
[24]胡学军,商洪才,张伯礼,等.生存质量及其量表在中医药疗效评价中的应用[J].天津中医药,2004,21(3)：191：191-193.
[25]王维治.神经病学[M].北京：人民卫生出版社,2005,(第5版)：130.
[26]陈主初.病理生理学[M].北京：人民卫生出版社,2006,(第1版)：285-286.
[27]Van Gieson EJ, Murfee WL, Skalak TC, et al. Enhanced smooth muscle ce 11 coverage of microvessels exposed to increased hemodynamic stresses in vivo[J]. Circ Res,2003,9(8):929-936.
[28]全世界对动脉粥样硬化血栓性疾病(AS)的流行情况、认识水平与治疗(JAMA,2006,295：184-189).高血压杂志,2006,14(4)：327.
[29]Sacco RL, Ellenberg JH, Mobr JP, et al. Infarcts of undetermined caus e:the NINCDS Stroke Data Ban k. Aan Neurol,1989,25:382-390.
[30]Salcuni M, Di Lazzaro V, Di Stasi C, et al. The role of Doppler US i n the study of carotid system[J]. Rays,1995,20(40):406-25.
[31]Polak JF,O'Leary DH, Kronmal RA, et al. Sonographic evaluation of c arotid artery atherosclerosis in the elderly:relationship of disease sev erity to stroke and transient ischemic attack[J]. Radiology,1993,188(2): 363-70.
[32]王拥军.应加强颈动脉粥样硬化的基础和临床研究[J].中华神经科学杂志,2001,34(5)：257-258.
[33]丁建平,华扬,王拥军,等.急性缺血性脑血管病患者脑动脉粥样硬化的分布[J].中华医学影像技术,2001,17(1)：29-31.
[34]章成国,张虹桥,谢坚,等.缺血性脑血管病与颈动脉粥样硬化的关系[J].中华神经病学杂志,2006,39(2)：832-835.
[35]曾桄伦,邵燕,章成国.颈动脉粥样硬化与脑梗死复发的关系[J].临床神经病学杂志,2005,18(1)：61-61.
[36]陈主初.病理生理学.北京：人民卫生出版社,2006,(第1版)：170-171.
[37]Durand E, Seoagee A, Lafont A, et al. In vivo induction of endotheli al apoptosis leads to vessel thrombosis and endothelial denudation:a clu e to the undemtanding of the mechanisms of thrombotic plaque erosion[J]. Circulation,2004,109:2503-2506.
[38]Esposito K, Marfalla R, Ciotola M, et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammatio n in the metabolic syndrome:a randomized trial[J]. JAMA,2004,292(12):14 40-1446.
[39]Lip GY, Blann A. von Willebrand factor:a marker of endothelial dysfun ction in vascular disorders[J]? Cardiovasc Res,1997,34:255-265.
[40]Spencer CGC, Gumey D, Blann AD, et al. Van willebrand factor, solubl e P-selectin, and target organ damage in hypertension:A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial[J]. Hypertension,2002,40:61-66.
[41]汪艳,任明山.脑梗死患者血液vWF和VEGF含量的动态变化及临床意义[J].临床输血与检验,2008,10(3)：215-217.
[42]周有利,付萍,毛达勇,等.CD62p、CD63和vWF在脑梗死患者中的临床意义[J].国际检验医学杂志,2007,28(8)：766、768.
[43]刘靖,杨靓,孙宁玲,等.微量白蛋白尿及假性血友病因子与高血压代谢综合征的关系[J].北京大学学报(医学版),2007,39(6)：587-590.
[44]纪求尚,张运,郭媛媛,等.急性心肌梗死患者促凝因子的动态变化及意义[J].山东大学学报(医学版),2004(42)3：284-286.
[45]Inoue M, Itoh H, Veda M, et al. Vascular endothelial growth factor (VEGF) expression in human coronary atherosclerotic lesions[J]. circulati on,1998,98(20):2108-2116.
[46]Tenaglia AN, Peters KG, Sketch MH, et al. Neovascularization in athe rectomy specimens in patients with unstable angina[J]. Am Heart,1998, (1) 135:10-14.
[47]Leek RD, Hunt NC, Landers RJ, et al. Macrophage infiltration is asso ciated with VEGF and EGFR expression in breast cancer[J]. J Pathol,2000, 190(4):430-436.
[48]朱其秀,卢瑞春,谭兰,等.颈动脉粥样硬化狭窄患者血管内皮生长因子检测及意义.中风与神经疾病杂志[J],2007,24(5)：596-597.
[49]关德明.动脉粥样硬化形成机制研究进展[J].哈尔滨医科大学学报,1999,33(6)：502-504.
[50]吕琳,鹿克凤,罗静等.氟伐他汀对兔动脉粥样硬化血管壁NF-κB和PDGF表达的影响[J].临床心血管病杂志,2005,21(8)：478-481.
[51]Ohara Y, Peterson T E, Sayegh H S, et al. Dietary correction of hype rcholesteralemia in the rabbit normalizes endothelial superoxide amon pro duction[J]. Circulation,1995,92:898-903.
[52]Valeric B1, Bruce A. Interactions between nitre oxide and lipid oxid ation pathways[J]. Cric Res,2001,88:12-21.
[53]卢兴国,童杰峰,张强,等.血浆凝血酶调节蛋白检测的临床应用[J].中国病理生理杂志,2007,23(7)：1451-1453.
[54]Giesen PL, RauehU, Bohrmarm B, et al. Blood-borne tissue factor:ano ther view of thrombosis[J]. Proc Nail Aead.Sci USA,1999,96:2311-2315.
[55]卢兴国,潘智勇,赵小英,等.心脑血管病和糖尿病相互合并与血浆凝血酶调节蛋白水平的变化[J].微循环技术杂志：临床与实验,2004,8(5)：348-349.
[56]奕泉根,卢兴国,朱蕾,等.血浆凝血酶调节蛋白在评估血管病变和并发症中的意义[J].中国微循环,2005,9(6)：417-419.
[57]王朝晖,龚平,杜林林,等.动脉粥样硬化并发血栓形成家兔模型的研究[J].中国病理生理杂志,2006,22(10)：2071-2073.
[58]高奋,李静梅,肖传实,等.高同型半胱氨酸血症兔模型动脉粥样硬化的形成[J].中国动脉硬化杂志.2002,10(4)：348.
[59]刘录山,杨永宗,冯大明,等.小型猪动脉粥样硬化斑块稳定性模型研究[J].生物化学与生物物理进展,2006,33(2)：196-200.
[60]Shi XY. Modem medicine animal experiment[M]. Bei jing:People S Mili tary Medicine Press,2000:470-472.
[61]马杰,郭力辉,张秀敏,等.鹌鹁动脉粥样硬化模型的探讨[J].动物学杂志,1997,32(2)：19-21.
[62]Reddick RL, Zhang SH, Maeda N. Aortic atheroscleroticplaque injury i n apolipoprotein E deficient mice[J]. Atherosclerosis 1998:140(2):297-3 05.
[63]Rekhter MD, shah N, Simari RD, et al. Animal model thatmimics athero sclerotic plaque rupture[J]. Circ Res 1998; 83(7):705-713.
[64]Joen RS, Ching HW. Mechanisms in the inhibition of neointimal hyperp lasis with triflavin in a rat model of balloon angioplast3[J]. J Lab Clin Med,2001,13(4):270.
[65]仲琳,张运,张梅,等.兔动脉粥样硬化易损斑块模型的建立[J].基础医学与临床,2005,25(4)：370-373.
[66]姜炜,郭阳.颈动脉内膜切除术后再狭窄动物模型的建立[J].天津医药,2007,2(35)：2.
[67]吴开云,高摄渊,袁融,等.维生素D3诱发大鼠动脉粥样硬化的实验研究[J].解剖学报,1996,27(2)：133-135
[68]沈丽,卢维晟,姚俊宇,等.不同方法建立动诛粥样硬化大鼠模型的比较[J].心脏杂志,2005,17(1)：18-20.
[69]温进坤,韩梅,杜玮南,等.一种快速建立大鼠动脉粥样硬化模型的实验方法[J].中国老年病学杂志,2001,21：50-52.
[70]Bujan J, Be Lloa JM, Sabater C, et al. Modifications induced by athe rogenie diet in the capacity of the arterial wall in rats to respond to s urgical insult[J]. Atherosclerosis,1996:122:141.
[71]郭延松,吴宗贵.鼠动脉粥样硬化模型复制方法的比较[J].中国动脉硬化杂志。2003,11(5)：465.
[72]杨鹏远,芮耀诚,焦亚斌,等.动脉粥样硬化大鼠实验模型的建立[J].第二军医大学学报,2003,24(7)：802-804.
[73]李秋梅,王硕仁,赵明镜.家兔新型动脉粥样硬化狭窄模型的建立及其动态观察[J].中国实验动物学报,2004,12(1)：26-28.
[74]Zhang SH, Reddick RL, Piedrahita JA et al. Spontaneous hypercholeste rolemia and arterial lesions in mice lacking apolipo protein E[J]. Scienc e 1992:258(5081):468-471.
[75]Traystman RJ. Animal models of focal and global cerebral ischemia[J]. ILAR,2003,44(2):85-95.
[76]Wang cx, rang Y, Yang T, et al. A focal embolic model of cerebral is chemia in rats:introduction and evaluation[J]. Brain Res Protoc.2001,7 (2):115-20.
[77]Krueger K, Busch E. Protocol of a thromboembolic stroke model in the rat:review of the experimental procedure and comparison of models[J]. In vest Radiol,2002,37(11):600-8.
[78]Sekiguehi M, Takagi K, Takagi N, et al. Time course and sequence of pathological changes in the cerebellum of microsphere embolized rats[J]. Exp Neurol,2005, (191):266-27.
[79]Ginsberg MD, Busto R. Rodent models of cerebral isehemia[J]. Stroke, 1989,20 (12):627-642.
[80]Sharkey J, Ritchie IM, Kelly PA. Perivascular microapplication of en dothelin-1:a new model of focal cerebral ischaemia in the rat[J]. J Cereb Blood Flow Metab,1993,13:865-821.
[81]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1)：55-56.
[82]中华医学会神经科学会.各类脑血管疾病的诊断要点[J].中华神经科杂志,1996,29(6)：379.
[83]Bamford J, Dennis M, Sandercock P, et al. The frequency, causes and timing of death within 30 days of acute stroke:the Oxfordshire Community Stroke Project (OCSP) [J]. J Neurology Neurosurg Psychiatry 1990:53:82 4-29.
[84]蔡业峰,付于,郭建文,等.中医药治疗急性缺血中风的多中心随机对照研究[J].中药材,2007,30(9)：1192-1195.
[85]蔡业峰,贾真,李伟峰,等.中文版Barthel指数对多中心测评缺血性卒中患者预后的研究[J].中国脑血管病杂志,2007,4(11)：486-490.
[86]Song F, Jerosch-Herold C, Holland R, et al, Statistical methods for a nalysing Barthel scores intrials of poststroke interventions:a review and computer simulations[J]. Clin Rehabil,2006,20:347-356.
[87]饶明俐.中国脑血管病指南[M].北京：人民卫生出版社,2007,(第1版)：2.
[88]Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community:is the "rule of halves" still valid [J]? J Hum Hypertens,1997,11:213-220.
[89]Basile JN, Bloch MJ. Identifying and managing factors that interfere with or worsen blood pressure contro[J]. Postgrad Med,2010,122(2):35-4 8.
[90]王增武,曹鲁琴,武阳丰,等.医疗卫生人员脑卒中相关知识、态度及行为水平的调查.中华内科杂志,2001,40：296-298.
[91]Rodriguez-Yanez M, Castellanos M, Blanco M, et al. New-onset hyperten sion and inflammatory response/poor outcome in acute ischemic stroke[J]. Neurology,2006,67(11):1973-8.
[92]High blood pressure and inflammation are associated with poor progno sis in lacunar infarctions. Cerebrovasc Dis,2006,22(2-3):123-9.
[93]丁国峰,毛艳华,石斗飞,等.老年高血压并缺血性脑卒中患者血浆同型半胱氨酸变化的临床意义[J].山东医药,2006,46(1)：30-31.
[94]陈东骊,莫与京,陈富荣,等.原发性高血压合并缺血性脑卒中与非对称性二甲基精氨酸及高敏C反应蛋白的相关性[J].广东医学,2008,29(5)：769-771.
[95]王少杰,袁晓梅,严东辉,等.中药醒脑静治疗自发性高血压脑卒中大鼠实验观察[J].中医杂志,1998,39(5)：303-304.
[96]钟广伟,李炜,陈民敬,等.天麻、钩藤、石决明、牡蛎、牛膝混合剂对高血压大鼠血管重构的影响[J].中华高血压杂志,2008,16(9)：812-816.
[97]余昭锐,王苓潇,陈燕.天麻素注射液治疗急性缺血性脑卒中的疗效观察[J].中国中西医结合杂志,2007,27(4)：377-378.
[98]顾天华,钱岳晟,张照英,等.黄芪与川芎在治疗自发性高血压大鼠中的相互作用研究[J].中国中西医结合杂志,2002,S1期.
[99]王亚玲,崔张新,李方红.丹参与川芎联合用药对冠心病患者脂代谢及血液流变性的影响[J].时珍国医国药,2009,20(9)：2169-2170.
[100]李可建.川芎嗪注射液治疗缺血性中风急性期随机对照实验的系统评价[J].时珍国医国药,2006,17(10)：1874-1876.
[101]陈治奎,胡申江,夏强,等.黄芪对自发性高血压大鼠的抗高血压效应及其机制的初步研究[J].中国实验诊断学,2008,12(6)：705-710.
[102]阮耀,黄川锋,岳兴如.黄芪预处理对大鼠脑缺血再灌注损伤的保护作用.时珍国医国药,2009,20(1)：103-104.
[103]郑峰,褚剑锋,熊尚全,等.灯盏细辛注射液治疗瘀证型高血压病的临床观察[J].广东医学,2007,28(2)：306-307.
[104]李娜,姜义,孙海欣,等.灯盏细辛注射液治疗急性脑梗死有效性的临床研究[J].首都医科大学学报,2008,29(3)：336-339.
[105]蔡业峰,张新春,郭建文,等.灯盏细辛注射液治疗缺血性中风急性期随机对照试验的Meta分析[J].广东医学,2007,28(8)：1335-1337.
[106]金明华,丘瑞香.华佗再造丸对缺血性中风患者血液流变性,SOD/MDA及NO调节的影响[J].中药材,1999,22(8)：427-428.
[107]刘金刚,李忠文,徐红梅,等.华佗再造丸抗血栓作用及对实验性微循环障碍的影响[J].广东医学,2000,21(5)：368-370.
[108]沈丽,卢维晟,姚俊宇,等.不同方法建立动脉粥样硬化大鼠模型比较[J].心脏杂志,2005,10(1)：18-20.
[109]顾国军,黄振兴,陶凯忠,等.HBO-1对内皮素-1诱导的大鼠局灶性脑缺血模型的疗效观察[J].第二军医大学学报,2006,27(10)：1134-1137.
[110]Zea Longa E1, W einstein PR, Carlson S, et a. Reversible middle cer ebral artery occlusion without craniectomy in rat [J]. Stroke,1989,20: 84-91.
[111]许良中,杨文涛.免疫组织化学反应结果的判断标准.中国癌症杂志,1996,6(4)：229-230.
[112]Blanco M, Rodriguez-Yanez M, Sobrino T, et al. Platelets, inflammat ion, and atherothrombotic neurovascular disease:the role of endothelial dysfunction. Cerebrovasc Dis.2005,20 (2):32-9.
[113]温绍君,叶平,李家增.动脉粥样硬化与易损斑块[J].中华内科杂志,2006,45(3)：259-260.
[114]陈小明.一氧化氮和心血管疾病(待续)[J].中华高血压杂志,2008,16(9)：847-848.
[115]陈小明.一氧化氮和心血管疾病(续二)[J].中华高血压杂志,2008,16(11)：1041-4042.
[116]Viswambhara H, Carvas JM, Antic V, et al. Mutation of the Circadian Clock Gene Per2 Alters Vascular Endothelial Function[J]. Circulation,20 07,115:2188.
[117]Vercauteren M, Remy E, Devaux C, et al. Improvement of Peripheral E ndothelial Dysfunction by Protein Tyrosine Phosphatase Inhibitors in Hear t Failure[J]. Circulation,2006,114:2498.
[118]Forstermann U, Mugge A, Alheid U, et al. Selective attenuation of e ndothelium-mediated vasodilation in atherosclerotic human coronary arteri es[J]. Circ. Res.,1988,62,185-190.
[119]Hirata Y, Nagata D, Suzuki E, et al. Diagnosis and treatment of end othelial dysfunction in cardiovascular disease[J]. Int Heart J,2010,51 (1):1-6.
[120]Pang J, Xu Q, Xu X, et al. Hexarelin suppresses high lipid diet and vitamin D3-induced atherosclerosis in the rat[J]. Peptides,2010,31(4): 630-8.
[121]Ruggeri, Z. M. Platelets in atherothrombosis[J]. Nat. Med,2002,8: 1227-1234.
[122]Dvorak HF, Brown LF, Detar M, et al. Vascular permeabi 1 ity factor /vascular endothel ial growth factor, microvascular, hyperpermeability, and angiogenesis [J]. Am J Pathol,1995,146(5):1029.
[123]赵仙先,朱家麟.血管内皮生长因子在动脉粥样硬化斑块中的表达[J].第二军医大学学报,1999,20(9)：669-671.
[124]李健芝,常青,唐海兰,等.丙二醛、ET—1、VEGF在动脉粥样硬化形成过程中的动态变化.解剖学杂志,2003,26(1)：7-11.
[125]张克俭,刘煜敏,张丽,等.PAI-1、u-PA、VEGF、CD34在动脉粥样硬化鼠急性脑缺血中的表达及意义[J].武汉大学学报：医学版,2007,28(6)：711-714.
[126]陈建华,刘晓娟,曾鸿,等.脑出血与脑梗死患者血清VEGF水平动态变化的研究.中国现代医学杂志,2008,18(5)：602-604.
[127]刘亢丁,潘成利,宫萍,等.脑梗死患者急性期血清VEGF含量变化及临床意义.吉林大学学报：医学版,2003,29(3)：345-346.
[128]李静,陈可冀.血小板衍化生长因子(PDGF)与动脉粥样硬化[J].生命科学,1995,7(1)：5-10.
[129]Ross R, Bowen-Pope DF, Raines EW, et al. Platelet derived growth fa ctor and its role in health and disease [J]. Phlos Ttmas R Soc Lond [Bio 1],1990,327(1239):155-169.
[130]韩英,谢良地,许昌声,等.氟伐他汀对大鼠血管平滑肌细胞迁移的影响及其机制.中国病理生理杂志,2005,21(11)：2133-2136.
[131]谢良地,吴可贵,陈达光,等.血小板源生长因子诱导血管平滑肌细胞迁移及机制[J].中国动脉硬化杂志,1998,6(1)：10-14.
[132]Au P, Tam J, Duda DG, et al. Paradoxical effects of PDGF-BB overexp ression in end-othelial cells on engineered blood vessels in vivo[J]. Am J Pathol,2009,175(1):294-302.
[133]Briede JJ, Wielders SJ, Heemskerk JW, et al. Von Willebrand factor s timulates thrombin-induced exposure of procoagulant phospholipids on the surface of fibrin-adherent platelets[J]. J Thromb Haemost,2003,1(3): 559-565.
[134]Kohler HP, Grant PJ. Plasminogen activator inhibitor type 1 and coro nary artery disease[J]. N Engl J Med,2002,342:1792-1800.
[135]Vandewouwer M, Collen D, Conway EM. Thrombomdulin protein C-EPCR sys tem[J]. Biology,2004,24:1374-1385.
[136]张蕾,孙旦澄,张燕香.脑梗死和心肌梗死患者血栓调节蛋白的检测及临床应用[J].检验医学,2005,20(1)：40-41.
[137]Olivot JM, Labreuche J, Aiach M, et al. Soluble thrombomodulin and b rain infarction:case-control and prospective study[J]. Stroke,2004,35 (8):1946-1951.
[138]于逢春,翟艳苓,刘艳,等.急性脑梗死患者血浆组织因子及血栓调节蛋白的研究[J].北京医学,2006,28(4)：196-198.
[139]Yokota H. Cerebral endothelial damage after severe head injury[J]. N ippon Med Sch,2007,74(5):332-7.
[140]Nomura E, Kohriyama T, Kozuka K, et al. Significance of serum solub le thrombodulin level in acute cerebral infarction[J]. Eur Jneurol,2004, 11(5):329-334.
[141]Ariyarajah V, Dawe DE, Khadem A. Is there a role for statins in atr ial fibrillation [J]? Pacing Clin Electrophysiol,2009,32(8):1063-72.
[142]曲莉,刘宗武,赵学忠.他汀类药物多效性研究进展[J].中国老年学杂志,2010,30(2)：280-282.
[143]陈竺.全国第三次死因回顾抽样调查报告-中华人民共和国卫生部[R].北京：协和医科大学出版社,2008,10.