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目的 :探讨急性脑梗死 (ACI)患者始发状态证候量值评分与内皮素 (ET)和胰岛激素的相关关系。方法 :1对 338例 ACI始发状态患者进行了中风辨证量化诊断调查 ;2采用放射免疫分析 (RIA)法检测 2 6 6例ACI患者血浆 ET、胰岛素 (INS)和胰高血糖素 (GL U)的变化 ;3分析评分与指标之间的相关关系 ,并与 30名正常健康人组作对照。结果 :1痰湿证量值与 ET含量关系最为密切 (r=0 .72 ,P<0 .0 1) ,其次为风证、火热证及血瘀证 (r=0 .38～ 0 .4 6 ,P均 <0 .0 1) ;2气虚证与阴虚阳亢证则无此变化 (r=0 .14～ 0 .16 ,P均 >0 .0 5 ) ;3各证候 ET水平与健康对照组比较 ,差异均非常显著 (P均 <0 .0 1) ;4风证、火热证、痰湿证及血瘀证量值评分与血浆 INS、GL U水平呈高度相关 (r=0 .33～ 0 .5 7,P均 <0 .0 1) ,与阴虚阳亢证呈显著性相关 (r=0 .2 1,P<0 .0 5 ) ;与气虚证无关 (r=0 .13,P>0 .0 5 ) ;5 ACI患者血中 INS及 GL U水平显著高于健康人组 (P均 <0 .0 1)。结论 :ET、INS和 GL U参与了 ACI中医证候的发生与发展过程 ,其变化特点与中医病因病机相符合 ,ET并成为 ACI的脑病理基础之一。
Objective: To investigate the relationship between the score of onset state syndrome and endothelin (ET) and islet hormones in patients with acute cerebral infarction (ACI). Methods: 1 338 patients with ACI-onset status were diagnosed by quantitative diagnosis of diastolic dysfunction.2 Radioimmunoassay (RIA) was used to detect plasma ET, insulin (INS) and glucagon (GLU) in 266 patients with ACI ); 3 analysis of the correlation between score and indicators, and with 30 normal healthy control group. Results: 1 The value of phlegm dampness syndrome was most closely related to ET content (r = 0.72, P <0.01), followed by wind syndrome, fiery syndrome and blood stasis syndrome (r = 0.38-0.4 6, P <0.01); 2 Qi deficiency and yang hyperactivity syndrome did not change (r = 0.14 ~ 0.16, P all> 0.05) Compared with the healthy control group, the differences were significant (all P <0.01). The scores of 4 Fengzheng, Fetal Heat, phlegm-dampness syndrome and blood stasis syndrome were highly correlated with plasma INS and GL U levels (r = 0 .33 ~ 0. 57, P <0. 01), and was significantly correlated with yin deficiency and yang hyperactivity (r = 0.21, P <0.05) = 0.13, P> 0.05). 5 The levels of INS and GL U in patients with ACI were significantly higher than those in healthy people (all P <0.01). Conclusion: ET, INS and GL U are involved in the occurrence and development of TCM syndromes in ACI. The changes are in line with the etiology and pathogenesis of TCM. ET is one of the pathological basis of ACI.