急性脑梗塞患者血管内皮细胞活性因子的变化和活血化瘀对其影响的临床观察

Clinical Study on Active Factors of Vascular Endothelial Cells in Acute Cerebral Infarction Patients and Therapeutical Effect of Activating Blood Stasis

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中文关键词: 急性脑梗塞血管内皮因子中医辨证活血化瘀

英文关键词:acute cerebral infarction vascular endothelial cell Syndrome Differentiation of TCM activating blood flow and removing blood stasis

基金项目:

作者	单位
林松波	福建中医学院附属人民医院!福州350004
连祺周	福建中医学院附属人民医院!福州350004
梁晖	福建中医学院附属人民医院!福州350004
孙光	福建中医学院附属人民医院!福州350004
陈宗良	福建中医学院附属人民医院!福州350004
庞明	福建中医学院附属人民医院!福州350004

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中文摘要:

目的 :为探讨急性脑梗塞 (acutecerebralinfarction ,ACI)中医不同证型与血管内皮细胞的关系 ,以及活血化瘀对其影响。方法 :对 2 0名健康者及 66例ACI偏虚证和偏实证患者检测了血浆纤维溶解系统 ,前列环素系统以及第Ⅷ因子相关抗原等的水平 ,并对其中 45例患者进行随机分组 ,前瞻性的“活血化瘀”治疗 ,一组以东菱克栓酶 (Difibrasebatroboxobin ,DF 5 1 2 )加活血化瘀中药心脑合剂 ,另一组单用DF 5 1 2 ,观察对神经缺损评分和内皮细胞活性因子的影响。结果 :(1 )ACI患者血浆组织型纤溶酶原激活物 (TissuePlasminogenactivator,tPA)活性、活性型tPA、前列环素F1α(6 keto ProstaglandinF1α,PGF1α)下降 ,而Ⅷ因子相关抗原 (FactorⅧrelatedantigen ,ⅧR :Ag)水平升高 ,其中以偏实证患者改变更为显著 ;偏虚证患者除tPA升高外 ,其他指标无显著改变 ;(2 )治疗 1个月后 ,两组改善神经缺损评分值无显著性差异 ,但治疗组评分值改善速度稍快 ;(3 )中西药结合治疗能显著降低纤溶酶原激活物抑制物 (Plasminogenactivatorinhibitor,PAI)活性 ,ⅧR :Ag水平及血栓烷B2 (ThromboxaneB2 ,TXB2 )和PGF1α比值 ,提高活性型tPA值。结论 :ACI患者存在血管内皮损伤 ,偏实证患者较偏虚证患者内皮损伤更严重。结合活血化瘀?

英文摘要:

Objective: To investigate the level of plasma tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), 6 keto prostaglandin F 1α (PGF 1α ), thromboxane B 2(TXB 2), factor Ⅷ related antigen (Ⅷ R:Ag) in acute cerebral infarction (ACI) patients with different TCM syndrome type and the therapeutical effect of activating blood stasis (ABS). Methods: Plasma fibrolysin system, prostaglandin system, and Ⅷ R:Ag of 20 healthy subjects and 66 ACI patients were determined. The 45 of 66 cases were treated with ABS randomly and prospectively, 20 cases were treated by difibrase batroboxobin (DF 521), only 25 cases were treated by DF 521 together with Heart Brain Mixture (HBM), on activating blood stasis mixture, concurrently. Results: (1) The activity of tPA, ratio of tPA/(tPA+PAI) and level of PGF 1α decreased significantly, the level of Ⅷ R:Ag increased remarkably in ACI patients than those of the controlled subjects. (2)Between Differentiation of Deficiency and Excess Syndromes, the level of above index changed more remarkably in the case with Excess Syndrome. Insignificant change of index shown in Deficiency cases except activity of tPA. (3) No more improvement of nerve impairment was shown between group of DF 521 together with HBM and DF 521 alone within 30 days. However, the improvement of index such as level of Ⅷ R:Ag, ratio of tPA/(tPA+PAI) and TXB 2/PGF 1α showed significant change between the beginning and end of treatment of DF 521 with HBM group. Conclusions: The vascular endothelial impairment was more serious in ACI patients with Excess than those with Deficiency Syndrome. DF 521 combining with HBM could protect vascular endothelial cells and improve the fibrolytic system and prostaglandin system.

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