血瘀证型脑梗死患者急性期血浆LPA、CD62p表达及丹参川芎嗪注射液干预作用的临床研究
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摘要
目的:观察健康人与血瘀证型(BS)脑梗死(CI)患者急性期溶血磷脂酸(LPA)、血小板α颗粒膜蛋白(CD62p)的表达水平,观察不同面积、不同血瘀证积分、不同脑功能受损情况下LPA、CD62p表达水平的差别;观察常规治疗组及丹参川芎嗪注射液治疗组治疗后脑功能评分、血瘀证积分及LPA、CD62p的差别,探讨丹参川芎嗪注射液作为血瘀证型脑梗死患者急性期用药的机理。
方法:收集健康人30例,血瘀证型脑梗死患者60例,并将脑梗死病例随机分入常规组及治疗组。常规组酌情给予脱水降颅压、营养神经及拜阿司匹林等常规治疗,治疗组在常规治疗基础上加用丹参川芎嗪注射液10ml/次,1次/天,静滴14天。所有脑梗死病例于入院后第二天及治疗第14天清晨抽取空腹静脉血5ml,半小时内用高速离心机(4000转/分)离心10分钟,使血液分为血清和血浆两部分,分别置于-50℃冰箱保存,采用双抗体夹心酶联免疫吸附法(ELISA法)测定其血浆LPA、CD62p水平。结合患者脑神经功能缺损、血瘀证积分以及脑梗面积大小情况,分析血浆LPA、CD62p水平与神经功能缺损评分、血瘀证积分、脑梗面积大小的关系,并分析丹参川芎嗪注射液对血浆LPA、CD62p水平的影响。
结果:
1.入院时不同组别血浆LPA、CD62p水平:脑梗死患者血浆LPA(umol/L)、CD62p(%)表达水平分别为4.68±0.93、13.56±5.39,显著高于健康对照组(2.20±0.45,3.61±O.52),差异有统计学意义(P<0.01);常规组血浆LPA(umol/L)、CD62p(%)表达水平分别为4.66±0.98、13.41±5.72与治疗组之间(4.69±0.90、13.71±5.13)无显著差异,差异不具有统计学意义(P>0.05)。
2.入院时不同血瘀证积分患者血浆LPA(umol/L)、CD62p(%)水平分别为:轻度血瘀证(4.09±0.49,10.45±3.31),中度血瘀证(5.47±0.45,17.26±2.88),重度血瘀证(6.30±0.20,23.35±2.08),对比可见:轻度血瘀证<中度血瘀证<重度血瘀证,三组之间比较差异均有统计学意义(P<0.01)。
3.入院时不同梗死灶面积的LPA(umol/L)、CD62p(%)水平分别为:小面积(3.74±0.28,8.17±2.11),中等面积(4.84±0.67,14.36±3.37),大面积(6.27±0.19,23.39±2.26),对比可见:小面积<中等面积<大面积,三组之间比较差异均有统计学意义(P<0.01)。
4.入院时脑梗死患者病情轻重不同,LPA、CD62p水平不同:病人入院后按脑功能缺损评分高低分为轻、中、重3组,其血浆LPA(umol/L)、CD62p(%)水平分别为:病情轻(3.86±0.33,8.86±2.40),病情中度(5.03±0.52,15.40±1.85),病情重(6.21±0.22,22.74±2.41),可以看出LPA、CD62p的表达水平呈:重型>中型>轻型,各组之间差异显著,具有统计学意义(P<0.01)。
5.治疗后疗效差异显著:治疗组基本痊愈及显著进步人数分别为10例、14例,明显高于常规组(6例,10例),治疗组显效率及总有效率分别为80.0%、93.3%,均高于常规组的53.3%及73.3%,差异有统计学意义(P<0.05)。
6.治疗后血浆LPA、CD62p差异:治疗组治疗后LPA(umol╱L)、CD62p(%)水平分别为:3.01±0.95、4.61±2.64,均低于常规组的3.74±1.48、7.69±6.60,差异有统计学意义(P<0.05)。
7.按脑功能恢复情况分为基本痊愈、显著进步、进步、无变化、恶化,其对应LPA下降幅度(%)分别为:47.40±7.82、32.50±9.28、17.26±7.85、12.08±8.39、-7.04±9.37;对应CD62p下降幅度(%)分别为:73.50±7.40、63.80±10.75、56.57±14.78、27.22±16.42、-18.00±20.02,对比可见神经功能缺损恢复程度与LPA、CD62p下降幅度成直线相关(r分别为0.83、0.53,P<0.01)各组间差异具有统计学意义。
8.按脑功能恢复情况分为基本痊愈、显著进步、有效、进步、无变化、恶化,其对应血瘀证积分下降幅度分别为:84.81±9.63、68.47±14.35、38.71±13.38、40.02±35.09、-9.22±40.41,分析可见脑神经功能缺损恢复程度与血瘀证积分下降幅度成直线相关(r=0.71,P<0.01)。
结论:
1.急性脑梗死血浆LPA、CD62p表达水平与脑梗死病情轻重、脑梗死面积呈正相关,同时血浆LPA、CD62p表达水平的下降幅度与脑神经功能缺损的恢复程度相关,可在一定程度上反应脑梗死的发生、发展、转归情况。
2.LPA、CD62p水平与中医血瘀证积分呈正相关,可能反映了中医的血瘀程度,治疗后脑功能缺损恢复程度与血瘀证积分下降幅度成正相关,说明中医学的血瘀证理论与现代医学的血栓形成、体循环淤血等血管内血液凝固理论呈一定相关性。
3.丹参川芎嗪注射液可以对急性脑梗死患者血浆LPA、CD62p表达及中医血瘀情况进行有效干预,并改善其临床神经功能。
Objective:To look into the differentce of blood plasma lysophosphatidic acid(LPA) and P-selection(CD62p) between healthy grown-up and blood stasis ?acute cerebral thrombosis,at the same time,observe the change of blood plasma LPA and CD62p of different acute cerebral thrombosis area、different blood stasis degrees、different Neurological Severity Score(NSS)。To observe the levels of blood plasma LPA、D62p and NSS、blood stasis degree effected by danshen chuanxionqin injection,and further explain the possible mechanism of danshen chuanxionqin injection。
Methods:60 patients with blood stasis ´ cerebral thrombosis in hospital no more than 72 hours were randomly divided into group B1(routine treatment group) and group B2(dansh chuanxiongqin injection treatment group).30 cases(male20,female10,mean age 63.87±11.35) were served as B1,30 cases(malel9,female11,mean age 63.43±11.25) were served as B2.30 normal cases(malel8,female12,mean age 64.20±10.47 ) were served as group A(normal contrast group).Routine western medicine(including dehydration and degrading intracranial pressure,controling blood pressure,resisting platelet aggregation and degrading fibrinogen etc.) were given to 30patients of group Bl,and danshen chuanxiongqin injection was given to another 30patients of group B2 in addition.Vein blood samples were collected before breakfast in the second day and the fourteenth day after take into the hospital.Both LPA、CD62p were tested by ELISA.And then analysis the connection between the value of LPA、CD62p and NSS、blood stasis degree,and further explain the influence of danshen chuanxionqin injection to LPA、CD62p。
Results:1.The levels of blood plasma LPA、CD62p of group B(the cases with acute cerebral thrombosis) were markedly higher than those in group A(P＜0.01),the difference between group Bl and B2 is insignificant(P＞0.05).
2.The higher blood stasis degree,the levels of LPA、CD62p are higher.,the difference among the three groups are significant(P＜0.05).
3.The larger area of acute cerebral thrombosis,the levels of LPA、CD62p are higher(P＜0.01),the difference among the three groups are significant(P＜0.05).
4.The higher of NSS,the higher of LPA、CD62p(P＜0.05).
5.Group B2 surpasses group B1 obviously in neurologic impairment therapeutic effects(P＜0.05).
6.After treatment,the levels of LPA、CD62p of groupB2 are much lower than group B1(P＜0.05).
7.After treatment,the descend range of NSS is related to blood plasma LPA、CD62p(r=0.83, 0.53,P＜0.01)
8.After treatment,the descend range of NSS is related to blood stasis(r=0.71,P＜0.01)
Conclusions:1.The levels of ACTs' blood plasma LPA、CD62p are obviously higher than healthy grown up,at the same time,the level of LPA、CD62p are correspondence with the area and the disease' conditions.
2.The levels of blood plasma LJA、CD62p are correspondence with the degree of blood stasis,it could illuminated that the LPA、CD62p' level can reflect the blood plasma' degree, it could also illuminated that there is some relationship between the blood stasis' theory and modem gore theory.
3.Danshen chuanxionqin injection can effectly affect the prognosis of the patients who suffering blood stasis＆acute cerebral thrombosis,the prognosis is respond to the level of LPA、CD62p,it could be explained that danshen chuanxiongqin injection could restrain blood platelet's activation,it could restrain blood platelet adhere to injured endothelium,reduce the pathology damage from inflammation after cerebral ischemia,reduce the cerebral edema and improve the blood circulation of partial brain.
方法:收集健康人30例,血瘀证型脑梗死患者60例,并将脑梗死病例随机分入常规组及治疗组。常规组酌情给予脱水降颅压、营养神经及拜阿司匹林等常规治疗,治疗组在常规治疗基础上加用丹参川芎嗪注射液10ml/次,1次/天,静滴14天。所有脑梗死病例于入院后第二天及治疗第14天清晨抽取空腹静脉血5ml,半小时内用高速离心机(4000转/分)离心10分钟,使血液分为血清和血浆两部分,分别置于-50℃冰箱保存,采用双抗体夹心酶联免疫吸附法(ELISA法)测定其血浆LPA、CD62p水平。结合患者脑神经功能缺损、血瘀证积分以及脑梗面积大小情况,分析血浆LPA、CD62p水平与神经功能缺损评分、血瘀证积分、脑梗面积大小的关系,并分析丹参川芎嗪注射液对血浆LPA、CD62p水平的影响。
结果:
1.入院时不同组别血浆LPA、CD62p水平:脑梗死患者血浆LPA(umol/L)、CD62p(%)表达水平分别为4.68±0.93、13.56±5.39,显著高于健康对照组(2.20±0.45,3.61±O.52),差异有统计学意义(P<0.01);常规组血浆LPA(umol/L)、CD62p(%)表达水平分别为4.66±0.98、13.41±5.72与治疗组之间(4.69±0.90、13.71±5.13)无显著差异,差异不具有统计学意义(P>0.05)。
2.入院时不同血瘀证积分患者血浆LPA(umol/L)、CD62p(%)水平分别为:轻度血瘀证(4.09±0.49,10.45±3.31),中度血瘀证(5.47±0.45,17.26±2.88),重度血瘀证(6.30±0.20,23.35±2.08),对比可见:轻度血瘀证<中度血瘀证<重度血瘀证,三组之间比较差异均有统计学意义(P<0.01)。
3.入院时不同梗死灶面积的LPA(umol/L)、CD62p(%)水平分别为:小面积(3.74±0.28,8.17±2.11),中等面积(4.84±0.67,14.36±3.37),大面积(6.27±0.19,23.39±2.26),对比可见:小面积<中等面积<大面积,三组之间比较差异均有统计学意义(P<0.01)。
4.入院时脑梗死患者病情轻重不同,LPA、CD62p水平不同:病人入院后按脑功能缺损评分高低分为轻、中、重3组,其血浆LPA(umol/L)、CD62p(%)水平分别为:病情轻(3.86±0.33,8.86±2.40),病情中度(5.03±0.52,15.40±1.85),病情重(6.21±0.22,22.74±2.41),可以看出LPA、CD62p的表达水平呈:重型>中型>轻型,各组之间差异显著,具有统计学意义(P<0.01)。
5.治疗后疗效差异显著:治疗组基本痊愈及显著进步人数分别为10例、14例,明显高于常规组(6例,10例),治疗组显效率及总有效率分别为80.0%、93.3%,均高于常规组的53.3%及73.3%,差异有统计学意义(P<0.05)。
6.治疗后血浆LPA、CD62p差异:治疗组治疗后LPA(umol╱L)、CD62p(%)水平分别为:3.01±0.95、4.61±2.64,均低于常规组的3.74±1.48、7.69±6.60,差异有统计学意义(P<0.05)。
7.按脑功能恢复情况分为基本痊愈、显著进步、进步、无变化、恶化,其对应LPA下降幅度(%)分别为:47.40±7.82、32.50±9.28、17.26±7.85、12.08±8.39、-7.04±9.37;对应CD62p下降幅度(%)分别为:73.50±7.40、63.80±10.75、56.57±14.78、27.22±16.42、-18.00±20.02,对比可见神经功能缺损恢复程度与LPA、CD62p下降幅度成直线相关(r分别为0.83、0.53,P<0.01)各组间差异具有统计学意义。
8.按脑功能恢复情况分为基本痊愈、显著进步、有效、进步、无变化、恶化,其对应血瘀证积分下降幅度分别为:84.81±9.63、68.47±14.35、38.71±13.38、40.02±35.09、-9.22±40.41,分析可见脑神经功能缺损恢复程度与血瘀证积分下降幅度成直线相关(r=0.71,P<0.01)。
结论:
1.急性脑梗死血浆LPA、CD62p表达水平与脑梗死病情轻重、脑梗死面积呈正相关,同时血浆LPA、CD62p表达水平的下降幅度与脑神经功能缺损的恢复程度相关,可在一定程度上反应脑梗死的发生、发展、转归情况。
2.LPA、CD62p水平与中医血瘀证积分呈正相关,可能反映了中医的血瘀程度,治疗后脑功能缺损恢复程度与血瘀证积分下降幅度成正相关,说明中医学的血瘀证理论与现代医学的血栓形成、体循环淤血等血管内血液凝固理论呈一定相关性。
3.丹参川芎嗪注射液可以对急性脑梗死患者血浆LPA、CD62p表达及中医血瘀情况进行有效干预,并改善其临床神经功能。
Objective:To look into the differentce of blood plasma lysophosphatidic acid(LPA) and P-selection(CD62p) between healthy grown-up and blood stasis ?acute cerebral thrombosis,at the same time,observe the change of blood plasma LPA and CD62p of different acute cerebral thrombosis area、different blood stasis degrees、different Neurological Severity Score(NSS)。To observe the levels of blood plasma LPA、D62p and NSS、blood stasis degree effected by danshen chuanxionqin injection,and further explain the possible mechanism of danshen chuanxionqin injection。
Methods:60 patients with blood stasis ´ cerebral thrombosis in hospital no more than 72 hours were randomly divided into group B1(routine treatment group) and group B2(dansh chuanxiongqin injection treatment group).30 cases(male20,female10,mean age 63.87±11.35) were served as B1,30 cases(malel9,female11,mean age 63.43±11.25) were served as B2.30 normal cases(malel8,female12,mean age 64.20±10.47 ) were served as group A(normal contrast group).Routine western medicine(including dehydration and degrading intracranial pressure,controling blood pressure,resisting platelet aggregation and degrading fibrinogen etc.) were given to 30patients of group Bl,and danshen chuanxiongqin injection was given to another 30patients of group B2 in addition.Vein blood samples were collected before breakfast in the second day and the fourteenth day after take into the hospital.Both LPA、CD62p were tested by ELISA.And then analysis the connection between the value of LPA、CD62p and NSS、blood stasis degree,and further explain the influence of danshen chuanxionqin injection to LPA、CD62p。
Results:1.The levels of blood plasma LPA、CD62p of group B(the cases with acute cerebral thrombosis) were markedly higher than those in group A(P＜0.01),the difference between group Bl and B2 is insignificant(P＞0.05).
2.The higher blood stasis degree,the levels of LPA、CD62p are higher.,the difference among the three groups are significant(P＜0.05).
3.The larger area of acute cerebral thrombosis,the levels of LPA、CD62p are higher(P＜0.01),the difference among the three groups are significant(P＜0.05).
4.The higher of NSS,the higher of LPA、CD62p(P＜0.05).
5.Group B2 surpasses group B1 obviously in neurologic impairment therapeutic effects(P＜0.05).
6.After treatment,the levels of LPA、CD62p of groupB2 are much lower than group B1(P＜0.05).
7.After treatment,the descend range of NSS is related to blood plasma LPA、CD62p(r=0.83, 0.53,P＜0.01)
8.After treatment,the descend range of NSS is related to blood stasis(r=0.71,P＜0.01)
Conclusions:1.The levels of ACTs' blood plasma LPA、CD62p are obviously higher than healthy grown up,at the same time,the level of LPA、CD62p are correspondence with the area and the disease' conditions.
2.The levels of blood plasma LJA、CD62p are correspondence with the degree of blood stasis,it could illuminated that the LPA、CD62p' level can reflect the blood plasma' degree, it could also illuminated that there is some relationship between the blood stasis' theory and modem gore theory.
3.Danshen chuanxionqin injection can effectly affect the prognosis of the patients who suffering blood stasis＆acute cerebral thrombosis,the prognosis is respond to the level of LPA、CD62p,it could be explained that danshen chuanxiongqin injection could restrain blood platelet's activation,it could restrain blood platelet adhere to injured endothelium,reduce the pathology damage from inflammation after cerebral ischemia,reduce the cerebral edema and improve the blood circulation of partial brain.
引文
[1]陈灏珠《实用内科学》[M].第12版.北京:人民卫生出版社.2005.5:2665
[2]Laterum OD,Bjekness K.Flowcytometry in hemotogy[M].London:Academic Press,1999.153-163
[3]吕莉君,刘忠达,姚纯俭等.中风病急性期证型分析研究.[J].中国中医药信息杂志.2005,12(1):12-13
[4]饶明俐.《中国脑血管病防治指南》.中风与神经疾病杂志.2005.22(11).388-389
[5]郑筱萸.中药新药临床指导原则[M].北京:中国医药科技出版社,2002,4:99.
[6]万赛英,顾卫,谭锋,等.急性脑梗死病人血浆D-二聚体及 CD62p 含量的动态变化及其意义.中西医结合心脑血管病杂志.2006.4(4)298-299.
[7]脑卒中患者临床神经功能缺损程度评分标准[J].中华神经科杂志.1996,29(6):381.
[8]临床疗效评定标准[J].中华神经科杂志.1996,29(6):382.
[9]张介眉、陈国华.《中西医结合卒中单元》[M]中国医药科技出版社.2005.35-38
[10]周仲瑛.《中医内科学》[M]中国中医药出版社.320-321
[11]包祖饶,赵国平.试论缺血性中风气虚血瘀病机学说.[J].中医药研究.2001.17(5):4-5
[12]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性期的临床研究.[J]北京中医学院院报.1988:11(1):22-24
[13]张永悦,邵淑娟,施乐,等.补阳还五汤治疗中风急性期临床观察.天津中医.20004(2):885-888
[14]宋吉菊,于广湖,张华梅.杏丁注射液治疗缺血性脑卒中的临床观察及其对血浆LPA和AP的影响.疑难病杂志.2004.3(4)218-219
[15]姜兆顺,张胜兰,寇天芹.2型糖尿病血瘀证患者血小板CD62p、CD63p测定意义探讨.中国中西医结合杂志.1999.19(9)1321-1323
[16]陈健,陈治卿,梁立新.原发性高血压血瘀证患者活化血小板、胰岛素抵抗及动态血压变化特点.中国临床康复.2006.10(15)2004.3(4):422421
[17]陈可冀,薛梅,殷惠军.血小板活化与冠状动脉粥样硬化性心脏病和血瘀证的关系.首都医科大学学报2008.29(3):145-147
[17]马晓昌,杜建,陈可冀.冠心病心绞痛冠脉病变及中医证型与血小板膜糖蛋白、溶血磷脂酸的研究
[19]陈立英,廖仁吴,王敬.急性脑梗死患者血浆溶血磷脂酸水平检测的临床意义.临床和实验医学杂志.2007,6(6):90-91
[20]Fourcadc O,Simon MF.Lift L.et el.Propdol inhibits hw plmelct aggregation induced by pmipflAmnmtory fipid mediators.Anosth Am.2004,99(2):393-398.
[21]Panetti TS,Hannah DF,Averaamides C,et al.Extracellular matrix molecules regulate endothelial cell migration stimulated by lysophosphatidic acid.J Thromb Haemost,2004,2(9):1645-1656
[22]Panetti TS,Hannah DF,Averaamides C,et al.Extracellular matrix molecules regulate endothelial cell migration stimulated by lysophosphatidic acid.J Thromb Haemost,2004,2(9):1645-1656
[23]Ye X.Fukushima N,IGngsbury MA。ct el.Lysophosphafidic acid inftOtLr- signaling.Ncurorcport,2002,13:2169-2175.
[24]Malyszko J,Malyszko JS,Mysliwiec M.Markers of endothelial cell injury and thrombin activatable fibrinolysis inhibitor in nephritic syndrome[J].Blood Coagul Fibrinolysis,2002,13(7):615-621.[
25]田西菊,张东素,唐朝枢,等.急性脑梗死患者血浆溶血磷脂酸水平动态观察.中华神经科杂志.2005.37(5):445-446
[26]李军,沈志梅,马莉等.脑梗死患者活化血小板的检测及其临床意义.实用临床医约杂志,2006,10(4):52
[27]张文亚、顾苏兵.缺血性脑血管病患者血小板CD62p的变化及其临床意义.浙江实用医学.2002.7(1)13-14
1赵冉,陈超,陈卫新.缺血性脑卒中预警分析.中华中西医学杂志.2007.5(7):32-34
2吴昆鹏,雷长城.溶血磷脂酸的生物特性及其与冠心病的关系,中国心血管病研究杂志.2007.5(5):378-380
3 Siess W,Tigyi G.Thrombogenic and atherogenic activities of lysophosphatidic acid.J cell Biochem,2004,92(6):1086-1094
4.沈宏锐,刘俊艳.溶血磷脂酸及其与缺血性卒中的关心.国外医学神经病学神经外科分册.2005.32(1)92-95
5江波,江林涌,周汉良.磷脂酸和溶血磷脂酸的生理功能.生理科学进展.2002,33(2):159-162
6周国庆,李荣亨.溶血磷脂酸与动脉粥样硬化.中国老年学杂志.2005.25:1139-1142
7 Ye X,Fukushima N,IGngsbury MA.etal.Lysophosphafidic acid inflOtLr-signaling.Ncurorcport,2002,13:2169-2175.
8 余樱,张兆辉.溶血磷脂酸对血脑屏障通透性的影响.国际脑血管病杂志.2006,14(4):286-289
9 Spector AA.Plaque rupture,lysophosphatidic acid,and thrombosis.Circulation,2003,108:641-643.
10 Inoun T,Hoshi K,Fujito T,etal.Early detection of platelet activation afar coronary angioplastry.Coron Artery Dis 1996,7:529-534
11刘泽霖.血栓性疾病的诊断与治疗[M].北京:人民卫生出版社,2000,521-522
12张宗新.高血压患者D-D二聚体、CD62p及血液流变学观察.现代实用医学.2003,15(9):526-563
13黄日安,吴钊坤.糖尿病并微血管病变患者血小板 CD62p 及 CD63 的表达及其临床意义.中国老年学杂志,2007,27:1374
14杨月榕,罗助荣.血小板膜蛋白 CD63、CD62P 表达与高血压分级、危险度分层的关系及药物干预作用.心血管康复医学杂志.2001,10(4).303
15陈加俊,孙景春,韩雪梅.短暂脑缺血发作患者血小板膜糖蛋白 CD61、CD62p 表达及阿斯匹林干预的临床研究.中国实验诊断学.2004,8(2):166
16杨光,赵连东,周永等.奥扎格雷对急性脑梗死患者血小板 CD62p 和 CD63 表达的影响及其疗效.临床神经病学杂志.2006.19(5):371
17李军,沈志梅,马莉等.脑梗死患者活化血小板的检测及其临床意义.实用临床医药杂志,2006,10(4):52
18马民,陈利国.血瘀证患者血小板 CD62p 基因、白细胞 HSP70 基因的表达,中国中西医结合杂志.2005,25(4):307-310
[2]Laterum OD,Bjekness K.Flowcytometry in hemotogy[M].London:Academic Press,1999.153-163
[3]吕莉君,刘忠达,姚纯俭等.中风病急性期证型分析研究.[J].中国中医药信息杂志.2005,12(1):12-13
[4]饶明俐.《中国脑血管病防治指南》.中风与神经疾病杂志.2005.22(11).388-389
[5]郑筱萸.中药新药临床指导原则[M].北京:中国医药科技出版社,2002,4:99.
[6]万赛英,顾卫,谭锋,等.急性脑梗死病人血浆D-二聚体及 CD62p 含量的动态变化及其意义.中西医结合心脑血管病杂志.2006.4(4)298-299.
[7]脑卒中患者临床神经功能缺损程度评分标准[J].中华神经科杂志.1996,29(6):381.
[8]临床疗效评定标准[J].中华神经科杂志.1996,29(6):382.
[9]张介眉、陈国华.《中西医结合卒中单元》[M]中国医药科技出版社.2005.35-38
[10]周仲瑛.《中医内科学》[M]中国中医药出版社.320-321
[11]包祖饶,赵国平.试论缺血性中风气虚血瘀病机学说.[J].中医药研究.2001.17(5):4-5
[12]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性期的临床研究.[J]北京中医学院院报.1988:11(1):22-24
[13]张永悦,邵淑娟,施乐,等.补阳还五汤治疗中风急性期临床观察.天津中医.20004(2):885-888
[14]宋吉菊,于广湖,张华梅.杏丁注射液治疗缺血性脑卒中的临床观察及其对血浆LPA和AP的影响.疑难病杂志.2004.3(4)218-219
[15]姜兆顺,张胜兰,寇天芹.2型糖尿病血瘀证患者血小板CD62p、CD63p测定意义探讨.中国中西医结合杂志.1999.19(9)1321-1323
[16]陈健,陈治卿,梁立新.原发性高血压血瘀证患者活化血小板、胰岛素抵抗及动态血压变化特点.中国临床康复.2006.10(15)2004.3(4):422421
[17]陈可冀,薛梅,殷惠军.血小板活化与冠状动脉粥样硬化性心脏病和血瘀证的关系.首都医科大学学报2008.29(3):145-147
[17]马晓昌,杜建,陈可冀.冠心病心绞痛冠脉病变及中医证型与血小板膜糖蛋白、溶血磷脂酸的研究
[19]陈立英,廖仁吴,王敬.急性脑梗死患者血浆溶血磷脂酸水平检测的临床意义.临床和实验医学杂志.2007,6(6):90-91
[20]Fourcadc O,Simon MF.Lift L.et el.Propdol inhibits hw plmelct aggregation induced by pmipflAmnmtory fipid mediators.Anosth Am.2004,99(2):393-398.
[21]Panetti TS,Hannah DF,Averaamides C,et al.Extracellular matrix molecules regulate endothelial cell migration stimulated by lysophosphatidic acid.J Thromb Haemost,2004,2(9):1645-1656
[22]Panetti TS,Hannah DF,Averaamides C,et al.Extracellular matrix molecules regulate endothelial cell migration stimulated by lysophosphatidic acid.J Thromb Haemost,2004,2(9):1645-1656
[23]Ye X.Fukushima N,IGngsbury MA。ct el.Lysophosphafidic acid inftOtLr- signaling.Ncurorcport,2002,13:2169-2175.
[24]Malyszko J,Malyszko JS,Mysliwiec M.Markers of endothelial cell injury and thrombin activatable fibrinolysis inhibitor in nephritic syndrome[J].Blood Coagul Fibrinolysis,2002,13(7):615-621.[
25]田西菊,张东素,唐朝枢,等.急性脑梗死患者血浆溶血磷脂酸水平动态观察.中华神经科杂志.2005.37(5):445-446
[26]李军,沈志梅,马莉等.脑梗死患者活化血小板的检测及其临床意义.实用临床医约杂志,2006,10(4):52
[27]张文亚、顾苏兵.缺血性脑血管病患者血小板CD62p的变化及其临床意义.浙江实用医学.2002.7(1)13-14
1赵冉,陈超,陈卫新.缺血性脑卒中预警分析.中华中西医学杂志.2007.5(7):32-34
2吴昆鹏,雷长城.溶血磷脂酸的生物特性及其与冠心病的关系,中国心血管病研究杂志.2007.5(5):378-380
3 Siess W,Tigyi G.Thrombogenic and atherogenic activities of lysophosphatidic acid.J cell Biochem,2004,92(6):1086-1094
4.沈宏锐,刘俊艳.溶血磷脂酸及其与缺血性卒中的关心.国外医学神经病学神经外科分册.2005.32(1)92-95
5江波,江林涌,周汉良.磷脂酸和溶血磷脂酸的生理功能.生理科学进展.2002,33(2):159-162
6周国庆,李荣亨.溶血磷脂酸与动脉粥样硬化.中国老年学杂志.2005.25:1139-1142
7 Ye X,Fukushima N,IGngsbury MA.etal.Lysophosphafidic acid inflOtLr-signaling.Ncurorcport,2002,13:2169-2175.
8 余樱,张兆辉.溶血磷脂酸对血脑屏障通透性的影响.国际脑血管病杂志.2006,14(4):286-289
9 Spector AA.Plaque rupture,lysophosphatidic acid,and thrombosis.Circulation,2003,108:641-643.
10 Inoun T,Hoshi K,Fujito T,etal.Early detection of platelet activation afar coronary angioplastry.Coron Artery Dis 1996,7:529-534
11刘泽霖.血栓性疾病的诊断与治疗[M].北京:人民卫生出版社,2000,521-522
12张宗新.高血压患者D-D二聚体、CD62p及血液流变学观察.现代实用医学.2003,15(9):526-563
13黄日安,吴钊坤.糖尿病并微血管病变患者血小板 CD62p 及 CD63 的表达及其临床意义.中国老年学杂志,2007,27:1374
14杨月榕,罗助荣.血小板膜蛋白 CD63、CD62P 表达与高血压分级、危险度分层的关系及药物干预作用.心血管康复医学杂志.2001,10(4).303
15陈加俊,孙景春,韩雪梅.短暂脑缺血发作患者血小板膜糖蛋白 CD61、CD62p 表达及阿斯匹林干预的临床研究.中国实验诊断学.2004,8(2):166
16杨光,赵连东,周永等.奥扎格雷对急性脑梗死患者血小板 CD62p 和 CD63 表达的影响及其疗效.临床神经病学杂志.2006.19(5):371
17李军,沈志梅,马莉等.脑梗死患者活化血小板的检测及其临床意义.实用临床医药杂志,2006,10(4):52
18马民,陈利国.血瘀证患者血小板 CD62p 基因、白细胞 HSP70 基因的表达,中国中西医结合杂志.2005,25(4):307-310