| Objective The acute cerebral infarction is a common and frequently occurring disease. the cause of the disease is very complicated, in addition to common risk factors, there are some infections and adhesion molecules factors gradually be concerned by the medical profession. Infection within 1 week is considered to be the main factors in inducing acute cerebral infarction, recent infection stimulated the inflammatory response mediated by adhesion molecules, prompted the unstable plaque repeatedly split or rupture, accelerated thrombosis formation and resulted in cerebral infarction occurrence. In this study, we examined the expression level of adhesion molecule( s VCAM-1, s ICAM-1, s P-Selectin, s L-Selectin and s E-Selectin),inflammatory cell molecular( Hcy, CRP and WBC) and blood coagulation index(FIB, D-dimer) in patients who infected acute cerebral infarction recently; The aim of the study is to study the mechanism of adhesion molecules in recent infection of acute cerebral infarction and provide an objective basis for the diagnosis and treatment of different TCM syndrome types by analysising the relationship between adhesion molecules level and NIHSS, different syndromes of traditional Chinese medicine(TCM)and the expression of adhesion molecules, inflammatory cell molecules, blood coagulation index.Methods Observation group were 100 cases who infected with acute cerebral infarction recently and control group were 20 patients without evidence of recent infection stroke; in terms of age, gender, numerical indicators,there were no significant statistical difference. According to "Chinese Medicine Department of internal medicine common disease treatment guidelines",100 cases of recent infection in patients with acute cerebral infarction is divided into seven types:wind phlegm type,phlegm heat accumulation type, yin deficiency, Qi deficiency and blood stasis type, Stagnation of phlegm,phlegm heat in closed and vitality defeated off type. Detected Adhesion molecules by enzyme-linked immunosorbent assay; LDL, HCY,CRP, FIB, D-Dimer were detected by drawing blood. SPSS17.0 software was used for analysis and X2 test for count data, t-test was used for compariing between the two groups. Pearson correlation analysis for single variable analysis, pairwise comparison Scheffe method observation in acute cerebral infarction patients with different TCM syndrome types of adhesion molecules expression and related index number value; analysis of the correlation between adhesion molecules and NIHSS, FIB, D-dimer correlation, FIB and D-dimer.Results(1) Among 100 recent infection patients with acute cerebral infarction, belongs to wind phlegm type were 34 people, accounting for 34%; phlegm heat accumulation type 15 people, accounting for15%; Qi deficiency and blood stasis type of 14 people,accounting for 14%;Yin pneumatic type 12 people, accounting for 12%; the phlegm heat closed 8 people, accounting for 8%;confused by phlegm orifice type 9, accounting for 9%; Qi defeated off type 8 people, accounted for 8%.(2) The index comparison between observation group and control group: the expression of adhesion molecules, inflammatory cell molecules, blood coagulation in patients who recent infection in acute cerebral infarction had significantly increased.(3) Adhesion molecules and NIHSS, D-dimer correlation: Pearson correlation analysis shows that adhesion molecules and NIHSS,D-dimer were positively correlated in patients who recent infection in acute cerebral infarction;At the same time, D-dimer and fibrinogen was also positively correlated.(4) the F test between TCM syndromes and detection index: Through F test, there are significant differences in the adhesion molecules, HCY, CRP, FIB, WBC FIB and D-Dimer among the types of syndromes.(5) The detection of Scheffe between TCM syndrome and adhesion molecules: s VCAM-1: real type, wind phlegm and Yin pneumatic type, phlegm heat accumulation of phlegm heat in the closed type, Qi deficiency and blood stasis,stagnation of phlegm type, Genki defeated off type had significant difference; no significant difference of real type and wind phlegm evil heat sputum; s ICAM-1: wind phlegm and phlegm heat accumulation type, Yin pneumatictype, Genki defeated off type, Qi deficiency and blood stasis, stagnation of phlegm type had significant difference; and the phlegm heat closed type had no significant difference.s P-selectin: wind phlegmand phlegm heat accumulation type, Yin pneumatic type, phlegm heat inner closed type have obvious difference; and the deficiency of Qi and blood stasis, wind phlegm had no significant difference. s L-Selectin: wind phlegm and Yin pneumatic type, phlegm heat accumulation, phlegm heat in the closed, stagnation of phlegm, Genki defeated off type had significant difference; no significant difference with Qi deficiency and blood stasis type. s E-Selectin: wind phlegm and stagnation of phlegm, phlegm heat in closed, vitality defeated off type had significant difference; no significant difference between phlegm heat accumulation type and wind phlegm.(6) the situation Between TCM syndrome type and Hcy by Scheffe method: wind phlegm and Yin pneumatictype, phlegm heat in closed, stagnation of phlegm type had significant difference; there were no significant difference between e phlegm heat Fu empirical, Qi deficiency and blood stasis type and wind phlegm.(7) the situation between TCM syndrome type and CRP by Scheffe method : wind phlegm type and sputum heat Fu empirical, deficiency of Qi and blood stasis, yin deficiency and wind type, phlegm Mongolia orifices, strength failure removal had significant difference; there was no significant difference between phlegm heat closed type and wind phlegm.(8) the situation between TCM syndrome type and WBC by Scheffe method: in WBC index, wind phlegm type and Qi deficiency and blood stasis type, yin deficiency and wind, phlegm heat closed type, phlegm clear orifices, vitality lost off type had significant difference; there was no significant difference between sputum heat Fu empirical and wind phlegm.(9) the situation between TCM syndrome type and FIB by Scheffe method: in the FIB index, wind phlegm type and yin deficiency and wind have significant difference; phlegm heat closed type and phlegm heat and fu organ sthenia type, Qi deficiency and blood stasis type, pneumatic type of yin deficiency, Qi defeated off type had significant difference; wind phlegm type and phlegm heat closed had no significant difference.(10) the situation between TCM syndrome type and D-dimer by Scheffe method: in D-dimer by index, wind phlegm type and Qi deficiency and blood stasis type, pneumatic type of yin deficiency, phlegm heat closed type, phlegm clear orifices, vitality lost off type had significant difference; wind phlegm type and phlegm heat and fu organ sthenia type had no significant difference.Conclusion(1)the adhesion molecules activated by the recent infection can act as the risk factor for the acute cerebral infarction, and it can be used as the basis for judging the degree of acute cerebral infarction.(2)Acute cerebral infarction induced by recent infection may be related to the stroke triggered by pathologic wind in TCM.(3)In recent infection with acute cerebral infarction, the dominant TCM syndrome type is the wind phlegm stasis syndrome.(4)TCM syndromes of the recent infection in acute cerebral were related with adhesion molecules, CRP, WBC, Hcy, Fib and Ddimer.(5)The levels of adhesion molecule in recent infection patients with acute cerebral infarction was positively correlated with fibrinogen and D-dimer. |
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