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目的探讨脑血管病血淤证不同阶段血液系统及血管内皮细胞活性因子的改变。方法以脑血管硬化为血淤前期 ,急性脑梗塞为急性血淤期 ,脑卒中恢复期为慢性血淤期 ,分别观察血液流变学、血管内皮活性因子(tPA、PAI、PGFlα、TXB2、ⅧR:Ag、Fn)、抗脂质过氧化 (SOD、GSH、CAT、MDA)和微量元素 (Cu ++、Fe ++、Se ++、Zn ++)变化。结果①血淤前期脑血管硬化患者全血粘度、血浆粘度、全血还原粘度、血球压积、血沉K值增高 ,纤维蛋白原含量增高。脑血管硬化患者tPA活性降低、PAI活性增高 ,VOT后tPA活性增高、PAI活性降低。②急性血淤期以“痰”、“淤”为主的气虚血淤证 ,风痰血淤证 ,痰热腑实证 ,其纤溶系统活性下降 ,以tPA活性下降尤为显著 ;阴虚风动和肝阳上亢 ,其PGFlα下降显著 ,PGI2-TXA2 系统紊乱。③慢性血淤期患者中 ,肝阳暴亢证、痰热腑实证及气虚血淤证MDA含量显著增高 ,而SOD、GSH含量明显降低。痰热腑实证及阴虚风动证CAT含量明显降低。肝阳暴亢证、痰热腑实证、阴虚风动证和气虚血淤证血清硒含量显著降低 ,且与GSH含量变化呈正相关 ,阴虚风动证和气虚血淤证血清锌含量降低 ,且阴虚风动证血清铜降低 ,气虚血淤证则血清铁含量明显增高。结论脑血管病血淤证存在血淤前期、急性血淤期和慢性血淤期不同?
Objective To investigate the changes of blood and vascular endothelial cells in different stages of cerebrovascular disease caused by blood stasis syndrome. Methods Cerebrovascular sclerosis was early stage of blood stasis, acute cerebral infarction was acute stage of blood stasis, and stroke recovery stage was chronic stage of blood stasis. The changes of hemorrheology, vascular endothelial active factor (tPA, PAI, PGFlα, TXB2, ⅧR Ag, Fn), anti-lipid peroxidation (SOD, GSH, CAT, MDA) and trace elements (Cu ++, Fe ++, Se ++, Zn ++). Results ① The whole blood viscosity, plasma viscosity, whole blood viscosity, hematocrit, erythrocyte sedimentation rate (K) and plasma fibrinogen were increased in patients with cerebrovascular cirrhosis before priming stage. Patients with cerebrovascular sclerosis had lower tPA activity, higher PAI activity, higher tPA activity, and lower PAI activity after VOT. ② acute blood stasis “sputum”, “silt” mainly qi deficiency blood stasis syndrome, phlegm blood stasis syndrome, phlegm heat organs, fibrinolytic activity decreased to tPA activity was particularly significant decline; yin deficiency And hyperactivity of liver Yang, PGFlα decreased significantly, PGI2-TXA2 system disorders. ③ In patients with chronic blood stasis, MDA content of liver yang hyperactivity syndrome, phlegm heat organs and qi deficiency and blood stasis syndrome were significantly increased while the content of SOD and GSH was significantly decreased. Phlegm heat organs and yin yang deficiency syndrome CAT content decreased significantly. Liver yang hyperactivity syndrome, phlegm heat Fuzheng, yin deficiency and blood stagnation syndrome serum selenium content was significantly lower, and GSH content was positively correlated with yin deficiency and blood deficiency syndrome, qi deficiency and blood stasis syndrome serum zinc content decreased, And yin deficiency of serum copper decreased, qi deficiency blood stasis card serum iron content was significantly higher. Conclusions There is difference of blood stasis syndrome, acute blood stasis syndrome and chronic blood stasis syndrome in cerebrovascular disease blood stasis syndrome.