【摘要】 目的探讨急性脑梗死(ACI)不同中医证型患者血栓常规的变化及其意义。方法对256例ACI患者进行中医辨证分型,以及血栓常规[包括凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体、血管性血友病因子(v WF)和抗凝血酶Ⅲ(ATⅢ)]检测。对不同中医证型亚组之间的血栓常规结果及与正常对照组进行比较。结果本组ACI患者分为风火上炎证53例、风痰瘀阻证68例、痰热腑实证44例、气虚血瘀证47例和阴虚风动证44例。与正常对照组比较,各型亚组的APTT、ATⅢ水平明显降低,血Fib、D-二聚体、v WF水平明显升高(P<0.05~0.01),PT、TT的差异无统计学意义(均P>0.05);各型亚组之间PT、APTT和TT的差异无统计学意义。风痰瘀阻证亚组的血D-二聚体和v WF水平明显高于其他4亚组(P<0.05~0.01);风痰瘀阻证亚组的血Fib水平明显高于、血ATⅢ水平明显低于风火上炎证、气虚血瘀证和阴虚风动证亚组(P<0.05~0.01),但与痰热腑实证亚组的血Fib、ATⅢ水平无统计学差异(均P>0.05)。结论 ACI风痰瘀阻证型患者的血D-二聚体和v WF水平升高最明显,其可作为ACI风痰瘀阻证分型的参考指标。更多还原

【Abstract】 Objective To explore the changes and their significance of thrombotic markers in different Chinese medical syndrome types patients with acute cerebral infarction( ACI). Methods Two hundred and fifty-six patients with ACI were typed in accordance with different Chinese medical syndrome types. Thrombotic markers of all the subjects were detected,including prothrombin time( PT),activation part thrombin time( APTT),thrombin time( TT),fibrinogen( Fib),D-dimer,von willebrand factor( v WF),and antithrombin Ⅲ( ATⅢ). Those markers were compared among different Chinese medical syndrome types and with those of the normal control group. Results Among ACI patients were divided into the wind- fire upward-invading syndrome( 53 cases),the wind-phlegmstasis syndrome( 68 cases),the phlegm-heat-bowel excess syndrome( 44 cases),the qi-deficiency and blood- stasis syndrome( 47 cases) and the yin-deficiency and wind syndrome( 44 cases). Compared with the normal control group,the levels of APTT and ATⅢ in all the syndrome types were found to decrease apparently( P < 0. 05- 0. 01),and level of Fib,D-dimer and v WF to increase considerably( P < 0. 05- 0. 01),and PT and TT made no sense in statistics( all P > 0. 05). The differences of PT,APTT and TT among different syndrome types were not statistically significantly. The levels of D-dimer and v WF in patients with the wind-phlegm-stasis syndrome group were apparently higher than those in patients with the other four syndrome type groups( P < 0. 05- 0. 01). The level of Fib in the wind-phlegm-stasis syndrome was obviously higher than those of the wind- fire upward- invading syndrome group,the qi- deficiency and blood-stasis syndrome and the yin- deficiency and wind syndrome group while the level of ATⅢ was just the oppsite( P < 0. 05- 0. 01). The levels of Fib and ATⅢ in the wind-phlegm-stasis syndrome were discovered to have no statistic difference with phlegm-heat-bowel excess syndrome group( all P > 0. 05). Conclusions The levels of D-dimer and v WF in wind-phlegm-stasis syndrome are increased most apparently. Therefore,D-dimer and v WF could be taken as the reference to type the wind-phlegm-stasis syndrome.更多还原