Correlation Between Pathology Of Thrombosis And Traditional Chinese Medicine Syndromes In Acute Ischemic Stroke Patients

ObjectiveTo analyze the correlations between pathology of thrombosis and traditional Chinese medicine symdromes including yin and yang type and whether in the meridians or organs in acute ischemic stroke patients.To study the influence on Prognosis caused by pathology of thrombosis and traditional Chinese medicine symdromes.Methods48cases of acute ischemic stroke patients, who were undergone Mechanical thrombectomy treatment from January2010to August2013in encephalopathy center of Guangdong Hospital of Traditional Chinese Medicine, were enrolled in this retrospective study.Included patients’s general informations, diagnosis, type of stroke (whether occurs in meridians or organs) and yin or yang syndrome distribution, risk factors, responsibility lesions, pathology of the thrombosis and other data were recorded. Referring to similar studies, vascular patency, surgical complications (mainly symptomatic intracranial hemorrhage) and mRS score recorded at discharge and telephone follow-up, survival or death and causes of death and other indexes were recorded to evaluate the prognosis of mechanical thrombectomy treatment.Choose appropriate statistical methods to analyze the correlations between pathology of thrombosis and traditional Chinese medicine symdromes including yin and yang type and whether in the meridians or organs in acute ischemic stroke patients. Study the influence on Prognosis caused by pathology of thrombosis and traditional Chinese medicine symdromes.Results 22thrombi(45.83%) are classified as white thrombi,14(29.17%) mixed thrombi,12(25.00%) red thrombus.14thrombi (29.17%) contain macrophage-derived foam cells which endocytose lipid,36thrombi (75%)with endothelia-lization,16thrombi(33.3%) with vascular smooth muscle. Etiological and clinical pathological diagnosis, TCM type of stroke, yin and yang type shows no statistically significant correlation. Influencing factors of prognosis include:age, sex, yin or yang type and TCM type of stroke, clinical risk factors including atrial fibrillation, hypertension, diabetes, smoking, pathology including proportion of red blood cells, volume of thrombi, staining result of CD68, CD31, F-Ⅷ factor, Vimentin (Vim) and Alpha Smooth Muscle Actin (SMA).ConclusionThrombi of patients with acute ischemic stroke are similar in pathological composition, which is the basis of antiplatelet and anticoagulant therapy. There are macrophage-derived foam cells in some thrombi endocytosing lipid, which provides basis for stable plaque and lipid-lowering therapy. Endothelia-lization is found in some thrombi, which may affect the benefit of thrombolysis and embolectomy therapy. Vascular smooth muscle can be found in some thrombi, which means that thrombectomy can damage membrane of the artery.There is no obvious correlation between pathology of thrombi and Etiological diagnosis, TCM type of stroke, yin and yang syndromes. The study found that older patients, female, patients with yang syndrome, patients occurred in the organs, patients with atrial fibrillation, hypertension, diabetes, smoking history and patients with greater volume of thrombi, higher proportion of red blood cells in thrombi, positive CD68staining, endothelialization and vascular smooth muscle damaged have the worse prognosis.