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目的研究急性脑梗死辨证分型与磁共振表观扩散系数(ADC)、同型半胱氨酸(Hcy)及超敏C反应蛋白(hs-CRP)的相关性。方法 140例急性脑梗死患者作为急性脑梗死组,中医辨证分型:风痰火亢型14例,风火上扰型13例,痰热腑实型20例,风痰瘀阻型36例,痰湿神蒙型9例,气虚血瘀型23例,阴虚风动型25例。行健康体检的50例志愿者作为对照组。比较两组ADC、Hcy及hs-CRP水平,观察和分析脑梗死辨证分型与ADC、Hcy及hs-CRP间的相关性。结果急性脑梗死组Hcy、hs-CRP、ADC水平分别为(16.79±4.55)μmol/L、(5.67±4.63)mg/L及(1.21±0.17)×10~(-9) m~2/s,对照组Hcy、hs-CRP、ADC水平分别为(11.26±3.86)μmol/L、(1.70±0.82)mg/L及(2.55±0.18)×10~(-9) m~2/s,两组比较差异均有统计学意义(P<0.05)。风痰瘀阻型Hcy水平与其他分型比较差异均有统计学意义(P<0.05)。痰热腑实型、风火上扰型、风痰火亢型hs-CRP水平与阴虚风动型、气虚血瘀型、风痰瘀阻型、痰湿神蒙型比较差异均具有统计学意义(P<0.05)。不同证型ADC值比较差异均无统计学意义(P>0.05)。结论急性脑梗死发生时机体Hcy及hs-CRP水平明显上升,ADC值明显下降,可见ADC值、Hcy、hs-CRP指标可作为急性脑梗死辨证分型的重要指标。
Objective To study the relationship between syndrome differentiation and apparent diffusion coefficient (ADC), homocysteine (Hcy) and high sensitivity C-reactive protein (hs-CRP) in acute cerebral infarction. Methods 140 patients with acute cerebral infarction as acute cerebral infarction group, TCM syndrome type: 14 cases of wind phlegm hypersensitivity, 13 cases of wind-fire on the disturbance type, 20 cases of phlegm-heat type, 36 cases of phlegm-stasis type, 9 cases of phlegm-dampness type, 23 cases of qi deficiency and blood stasis type, and 25 cases of yin-deficiency type. Fifty healthy volunteers were selected as control group. The levels of ADC, Hcy and hs-CRP were compared between the two groups. The correlation between syndrome differentiation of cerebral infarction and ADC, Hcy and hs-CRP was observed and analyzed. Results The levels of Hcy, hs-CRP and ADC in acute cerebral infarction group were (16.79 ± 4.55) μmol / L and (5.67 ± 4.63) mg / L and (1.21 ± 0.17) × 10 -9 m 2 / s , And the levels of Hcy, hs-CRP and ADC in the control group were (11.26 ± 3.86) μmol / L and (1.70 ± 0.82) mg / L and (2.55 ± 0.18) × 10 -9 m 2 / s, The difference was statistically significant (P <0.05). Phlegm stasis type Hcy levels compared with other types of differences were statistically significant (P <0.05). Phlegm heat type real wind-fire on the perturbing type, wind phlegm fire hyperthyroidism hs-CRP levels and yin deficiency type, qi deficiency and blood stasis type, phlegm stasis type, Significance (P <0.05). There was no significant difference in ADC value between different syndromes (P> 0.05). Conclusions The levels of Hcy and hs-CRP in acute cerebral infarction were significantly increased and the ADC value was significantly decreased. ADC value, Hcy, hs-CRP index could be used as an important index for the syndrome differentiation of acute cerebral infarction.