急性缺血性中风血瘀证与血浆HCY颈动脉粥样硬化关系的研究
|
摘要
目的:探讨急性缺血性中风血瘀证与血浆Hcy水平、颈动脉粥样硬化的关系。方法:将70例首次发作急性缺血性中风患者作为观察组,其中血瘀证组37例、非血瘀证组33例;将40例健康体检者作为对照组;观测并比较三组的血浆Hcy水平、颈动脉内中膜厚度(IMT)及粥样斑块分型、发生率。结果:观察组两组的血浆Hcy水平均显著高于对照组(P <0.01),且血瘀证组血浆Hcy水平较非血瘀证组高(P <0.01);观察组两组颈动脉IMT、斑块发生率均高于对照组(P <0.01),其中血瘀证组较非血瘀证组的颈动脉IMT、斑块发生率高(P <0.05);观察组两组不同分型的Hcy水平均高于对照组(P <0.05),且观察组两组稳定斑块及不稳定斑块分型的血浆HCY水平均显著高于同组无斑块分型的血浆Hcy水平(P <0.05)。结论:血浆Hcy水平、颈动脉粥样硬化与缺血性中风血瘀证密切相关。
Objective: To investigate the relationship between blood stasis syndrome of acute ischemic stroke and plasma homocysteine(Hcy) level and carotid atherosclerosis(CAS). Method: 70 cases of the first attack of acute ischemic stroke were selected as the observation group, including 37 cases of blood stasis syndrome group and 33 cases of non blood stasis syndrome group; 40 healthy subjects were selected as control group; Plasma Hcy level, carotid artery intima-media thickness(IMT) and atheromatous plaque typing and incidence were observed and compared between the 3 groups. Results: The plasma Hcy level in the 2 groups of the observation group was significantly higher than that of the control group(P<0.01), and the plasma Hcy level of the blood stasis syndrome group was higher than that of the non blood stasis syndrome group(P<0.01); The carotid artery IMT and incidence of plaque in the 2 groups of the observation group was higher than that of the control group(P<0.01), and the carotid artery IMT and incidence of plaque in the blood stasis syndrome group was higher than that of the non blood stasis syndrome group(P<0.05); The plasma Hcy level of the 2 groups in the observation group was both higher than that of the control group(P<0.05), and the level of plasma Hcy in the two groups of stable plaques and unstable plaques was significantly higher than that of the same group without plaques(P<0.05). Conclusion: Plasma Hcy level and CAS were closely related to blood stasis syndrome of ischemic stroke.
Objective: To investigate the relationship between blood stasis syndrome of acute ischemic stroke and plasma homocysteine(Hcy) level and carotid atherosclerosis(CAS). Method: 70 cases of the first attack of acute ischemic stroke were selected as the observation group, including 37 cases of blood stasis syndrome group and 33 cases of non blood stasis syndrome group; 40 healthy subjects were selected as control group; Plasma Hcy level, carotid artery intima-media thickness(IMT) and atheromatous plaque typing and incidence were observed and compared between the 3 groups. Results: The plasma Hcy level in the 2 groups of the observation group was significantly higher than that of the control group(P<0.01), and the plasma Hcy level of the blood stasis syndrome group was higher than that of the non blood stasis syndrome group(P<0.01); The carotid artery IMT and incidence of plaque in the 2 groups of the observation group was higher than that of the control group(P<0.01), and the carotid artery IMT and incidence of plaque in the blood stasis syndrome group was higher than that of the non blood stasis syndrome group(P<0.05); The plasma Hcy level of the 2 groups in the observation group was both higher than that of the control group(P<0.05), and the level of plasma Hcy in the two groups of stable plaques and unstable plaques was significantly higher than that of the same group without plaques(P<0.05). Conclusion: Plasma Hcy level and CAS were closely related to blood stasis syndrome of ischemic stroke.
引文
[1]梁辉,李万英.硫酸氢氯吡格雷片联合瑞舒伐他汀钙片治疗急性脑梗死的临床观察[J].中西医结合心血管病电子杂志,2015,03(29):15-16.
[2]石炎川,陈跃鸿,原敏,等.血浆同型半胱氨酸与脑梗死及颈动脉粥样硬化相关性的研究[J].脑与神经疾病杂志,2011,19(02):141-143.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(04):246-257.
[4]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(01):55-56.
[5]高颖,马斌,刘强,等.缺血性中风证候要素诊断量表编制及方法学探讨[J].中医杂志,2011,52(24):2097-2101.
[6]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(01):1-8.
[7]李颖,彭海.高同型半胱氨酸血症家兔动脉粥样硬化发生机制的研究[J].中国神经免疫学和神经病学杂志,2004,11(04):206-209.
[8]张卫霞.脑梗死与高同型半胱氨酸的相关性探讨[J].中国实用医药,2013,08(36):112-113.
[9]栾琴.脑梗死与高同型半胱氨酸的相关性探讨[J].中国医药指南,2017,15(11):61-62.
[10]王靖东,吴承志,吕晓侠,等.血清同型半胱氨酸水平与脑梗死发生及颈动脉粥样硬化相关性的临床研究[J].中风与神经疾病杂志,2007,24(05):576-578.
[11]耿旭,马宾,王洪巨,等.同型半胱氨酸及高敏C反应蛋白与冠状动脉病变程度的关系[J].蚌埠医学院学报,2017,42(05):587-590.
[12]Chassin MR.Appropriate use of carotid endarterectomy.[J].New England Journal of Medicine,1998,339(20):1468-1471.
[13]丁建平,华扬,凌晨,等.彩超对急性脑梗塞患者颈动脉粥样硬化斑块的研究[J].中国医学影像技术,2000,16(09):747-748.
[14]Mathiesen EB,Bonaa KH,Joakimsen O.Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis:the tromso study.Circulation,2001,103(17):2171-2175.
[15]Gronholdt ML,Nordestgaard BG,Schroeder TV,et al.Ultrasonic echolucent carotid plaques predict future strokes.Circulation,2001,104:68-73.
[16]Xiong L,Deng YB,Zhu Y,et al.Correlation of carotid plaqueneovascu larization detected byusing contrast-en-hanced US with clinical symptoms[J].Radiology,2009,251(02):583-589.
[17]陈立勋,贺栋梁,王俊波.颈内动脉易损斑块的CTA新特征与脑梗塞关联性分析[J].中南医学科学杂志,2018,46(01):95-97.
[18]刘军莲,宋剑南.中医血瘀证本质研究概况[J].辽宁中医杂志,2006,33(09):1091-1093.
[19]张国平,刘华,别晓东.不同类型中风血瘀证患者血液流变学和凝血谱指标的研究[J].全科医学临床与教育,2006,04(03):204-205.
[20]杨银花,王佳宁,韩雪,等.血瘀证与其客观检测指标关联性研究进展[J].中医临床研究,2014,06(29):142-144.
[2]石炎川,陈跃鸿,原敏,等.血浆同型半胱氨酸与脑梗死及颈动脉粥样硬化相关性的研究[J].脑与神经疾病杂志,2011,19(02):141-143.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(04):246-257.
[4]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(01):55-56.
[5]高颖,马斌,刘强,等.缺血性中风证候要素诊断量表编制及方法学探讨[J].中医杂志,2011,52(24):2097-2101.
[6]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(01):1-8.
[7]李颖,彭海.高同型半胱氨酸血症家兔动脉粥样硬化发生机制的研究[J].中国神经免疫学和神经病学杂志,2004,11(04):206-209.
[8]张卫霞.脑梗死与高同型半胱氨酸的相关性探讨[J].中国实用医药,2013,08(36):112-113.
[9]栾琴.脑梗死与高同型半胱氨酸的相关性探讨[J].中国医药指南,2017,15(11):61-62.
[10]王靖东,吴承志,吕晓侠,等.血清同型半胱氨酸水平与脑梗死发生及颈动脉粥样硬化相关性的临床研究[J].中风与神经疾病杂志,2007,24(05):576-578.
[11]耿旭,马宾,王洪巨,等.同型半胱氨酸及高敏C反应蛋白与冠状动脉病变程度的关系[J].蚌埠医学院学报,2017,42(05):587-590.
[12]Chassin MR.Appropriate use of carotid endarterectomy.[J].New England Journal of Medicine,1998,339(20):1468-1471.
[13]丁建平,华扬,凌晨,等.彩超对急性脑梗塞患者颈动脉粥样硬化斑块的研究[J].中国医学影像技术,2000,16(09):747-748.
[14]Mathiesen EB,Bonaa KH,Joakimsen O.Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis:the tromso study.Circulation,2001,103(17):2171-2175.
[15]Gronholdt ML,Nordestgaard BG,Schroeder TV,et al.Ultrasonic echolucent carotid plaques predict future strokes.Circulation,2001,104:68-73.
[16]Xiong L,Deng YB,Zhu Y,et al.Correlation of carotid plaqueneovascu larization detected byusing contrast-en-hanced US with clinical symptoms[J].Radiology,2009,251(02):583-589.
[17]陈立勋,贺栋梁,王俊波.颈内动脉易损斑块的CTA新特征与脑梗塞关联性分析[J].中南医学科学杂志,2018,46(01):95-97.
[18]刘军莲,宋剑南.中医血瘀证本质研究概况[J].辽宁中医杂志,2006,33(09):1091-1093.
[19]张国平,刘华,别晓东.不同类型中风血瘀证患者血液流变学和凝血谱指标的研究[J].全科医学临床与教育,2006,04(03):204-205.
[20]杨银花,王佳宁,韩雪,等.血瘀证与其客观检测指标关联性研究进展[J].中医临床研究,2014,06(29):142-144.