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1、急性脑梗死患者血浆D-二聚体与中医辨证分型相关性研究作者：陈维铭,钱涯邻,王馨然【摘要】目的观察血浆D-二聚体在急性脑梗死(ACI)中医各证型中的分布特点及变化规律,探讨其对各证型ACI的防治意义。方法回顾研究152例ACI初诊患者,按照中医辨证分型标准分为风火上炎证、风痰瘀阻证、痰热腑实证、气虚血瘀证和阴虚风动证,定量测定发病第3、7、14日的血浆D-二聚体,并与健康对照组比较。结果ACI各证型在发病后第3日和第7日的血浆D-二聚体均明显高于健康对照组(P<0.05),且呈明显上升趋势(P<0.05);在上述两个时段,ACI
2、各证型的血浆D-二聚体升高程度各不相同,其中风痰瘀阻、痰热腑实和气虚血瘀证以痰血瘀阻为主的证型明显高于其他两型(P<0.05);第14日,ACI风火上炎证和阴虚风动证的血浆D-二聚体均接近健康对照组(P>0.05),气虚血瘀证和痰热腑实证较第7日稍有下降(P>0.05),仍明显高于健康对照组(P<0.01),而风痰瘀阻证较第7日进一步升高(P<0.05)。结论血浆D-二聚体与ACI痰、瘀证有显著相关性,可作为ACI分型研究和干预治疗的客观依据。【关键词】急性脑梗死;D-二聚体;中医辨证分型 Abstract
3、：ObjectiveTostudythedistributionfeatures9andthechangetendencyofD-dimerindifferentTCMsyndrome-typeswiththeacutecerebralinfarction(ACI)andexplorethesignificancefortheprophylaxisandtreatmentofACIofvarioussyndrome-types.MethodsClinicaldataof152patientsofACIwerereviewed.Accord
4、ingtothestandardsofTCMsyndrome-types,fivesyndrome-typeswereidentified,thatis,hyperactivityofwind-firesyndrome(HWF),windandphlegm-bloodstasissyndrome(WPBS),phlegm-heat-bowelexcesssyndrome(PHBE),Qi-deficiencyandblood-stasissyndrome(QDBS),andYin-deficiencyandwind-movesyndrom
5、e(YDWM).Onthe3rd,7thand14thdayaftertheACIoccurred,D-dimerwasdeterminedrespectivelyandthencomparedwiththatofthecontrolgroup.ResultsD-dimerinalloffiveTCMsyndrome-typesonthe3rdand7thdaywashigherthanthatofthecontrolgroup(P<0.05).Moreover,D-dimeronthe7thdaywasnoticeablyhigh
6、erthanthatonthe3rdday(P<0.05).However,D-dimerincreaseddifferentlyindifferentsyndrome-typesduringthetwoperiodswiththethreephlegmorblood-stasispredominantsyndrome-types(WPBS,PHBEandQDBS)significantlyhigherthantheothertwo.Onthe14thday,D-dimeofHWFandYDWMwasclosetothatofthe
7、controlgroup(P>0.05).D-dimerofQDBSandPHBE,decreasedcomparedwiththoseonthe7thday(P>0.05),9wereremarkablyhigherthanthoseofthecontrolgroup(P<0.01).However,D-dimerofWPBSsyndromewasapparentlyhigherthanthatonthe7thday(P<0.05).ConclusionD-dimerissignificantlyrelatedt
8、ophlegmandblood-stasissyndromesinACI,whichcouldbetheobjectivebasisforthefurtherstudyonTCMsyndrom
