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1、急性腦梗死患者血漿D-二聚體與中醫(yī)辨證分型相關(guān)性研究作者：陳維銘,錢(qián)涯鄰,王馨然【摘要】目的觀察血漿D-二聚體在急性腦梗死(ACI)中醫(yī)各證型中的分布特點(diǎn)及變化規(guī)律,探討其對(duì)各證型ACI的防治意義。方法回顧研究152例ACI初診患者,按照中醫(yī)辨證分型標(biāo)準(zhǔn)分為風(fēng)火上炎證、風(fēng)痰瘀阻證、痰熱腑實(shí)證、氣虛血瘀證和陰虛風(fēng)動(dòng)證,定量測(cè)定發(fā)病第3、7、14日的血漿D-二聚體,并與健康對(duì)照組比較。結(jié)果ACI各證型在發(fā)病后第3日和第7日的血漿D-二聚體均明顯高于健康對(duì)照組(P<0.05),且呈明顯上升趨勢(shì)(P<0.05);在上述兩個(gè)時(shí)段,ACI
2、各證型的血漿D-二聚體升高程度各不相同,其中風(fēng)痰瘀阻、痰熱腑實(shí)和氣虛血瘀證以痰血瘀阻為主的證型明顯高于其他兩型(P<0.05);第14日,ACI風(fēng)火上炎證和陰虛風(fēng)動(dòng)證的血漿D-二聚體均接近健康對(duì)照組(P>0.05),氣虛血瘀證和痰熱腑實(shí)證較第7日稍有下降(P>0.05),仍明顯高于健康對(duì)照組(P<0.01),而風(fēng)痰瘀阻證較第7日進(jìn)一步升高(P<0.05)。結(jié)論血漿D-二聚體與ACI痰、瘀證有顯著相關(guān)性,可作為ACI分型研究和干預(yù)治療的客觀依據(jù)。【關(guān)鍵詞】急性腦梗死;D-二聚體;中醫(yī)辨證分型 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
