| Objective:To study the correlation between fire-blood stasis syndrome and carotid atherosclerosis in patients with hypertension complicated with acute cerebral infarction,and to explore the role of carotid atherosclerosis in the pathological process of fire-blood stasis syndrome in patients with hypertension complicated with acute cerebral infarction.Methods:Using prospective and registered research methods,patients with hypertension complicated with acute cerebral infarction(within 72 hours of onset)and hypertensive patients(hypertensive group)were collected from Dongfang Hospital of Beijing University of Traditional Chinese Medicine,outpatient and inpatient of Beijing First Hospital of Integrated Traditional Chinese and Western Medicine.The general data,carotid ultrasonography and TCM syndrome scores were observed.Age,sex,smoking,drinking,diabetes mellitus,dyslipidemia,coronary heart disease,blood sugar,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,homocysteine,activated partial thromboplastin time,thrombin time,prothrombin time,fibrinogen content,carotid intima-media thickness were compared between cerebral infarction group and hypertension group.The differences of degree,plaque,stenosis and fire-stasis syndrome were analyzed by multiple regression analysis.The cerebral infarction group and cerebral infarction group were grouped according to the presence or absence of fire-stasis syndrome.The differences between the two groups and carotid atherosclerosis(carotid intima-media thickness,plaque,stenosis)were compared.The patients with hypertension complicated with acute cerebral infarction were divided into carotid artery stenosis group and carotid artery non-stenosis group.The differences of age,sex,smoking,drinking,diabetes mellitus,dyslipidemia,coronary heart disease,blood sugar,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,homocysteine and fire-stasis syndrome between stenosis group and non-stenosis group were compared.The correlation between fire-stasis syndrome and carotid atherosclerosis in patients with hypertension complicated with acute cerebral infarction was studied by multiple regression analysis.Results:1.A total of 255 cases were enrolled,130 cases of hypertension with acute cerebral infarction and 125 cases of hypertension.There were significant differences in male,smoking,diabetes mellitus,dyslipidemia,coronary heart disease,blood sugar,homocysteine,prothrombin time,carotid intima-media thickness,stenosis and fire-stasis syndrome between hypertensive patients with acute cerebral infarction and hypertensive patients(P<0.05);there were significant differences in age,alcohol consumption,total cholesterol,triglyceride,low density lipoprotein cholesterol.There were no significant differences in alcohol,high density lipoprotein cholesterol,activated partial thromboplastin time,thrombin time and fibrinogen content(P>0.05).2.Comparing hypertension patients with acute cerebral infarction and hypertension patients,the factors that were different were male,smoking,diabetes mellitus,dyslipidemia,coronary heart disease,blood sugar,homocysteine,prothrombin time,carotid intima-media thickness,stenosis and fire-stasis syndrome,then multivariate regression analysis,homocysteine(OR:1.090,95%CI:1.027-1.158),carotid artery intra-carotid artery syndrome.Membrane medial thickness(OR:18.949,95%CI:1.967-182.558),stenosis(OR:5.408,OR:5.408,95%CI:1.869-15.650),fire stasis syndrome(OR:4.168,95%CI:2.168,95%CI:2.018-8.612),diabetes(OR:0.109,95%CI:0.051-0.233),dyslipidemia(OR:0.309,95%CI:0.309,95%CI:0.153-0.23233),dyslipidemia(OR:0.309,95%CI:0.153-0.622)were the influencing factors of acute cerebral infarction.Logistic regression equation 6X7+2.942X9+1.688X10+1.428X11.3.The presence or absence of carotid plaque in the syndrome of fire-blood stasis and non-fire-blood stasis in patients with hypertension complicated with acute cerebral infarction.There was no significant difference in the intima-media thickness of carotid artery(P>0.05),but there was no significant difference in the intima-media thickness of carotid artery(P<0.05).There was no significant difference in the intima-media thickness of carotid artery,carotid plaque and stenosis between fire-stasis syndrome and non-fire-stasis syndrome in hypertension group(P>0.05).4.Among the patients with hypertension and acute cerebral infarction,43 cases were in carotid atherosclerosis stenosis group and 87 cases were in carotid atherosclerosis stenosis-free group.There were significant differences in age,blood sugar and fire-stasis syndrome between carotid atherosclerosis stenosis group and non-stenosis group(P<0.05).Age,blood sugar and fire-stasis syndrome were different between the two groups by multivariate regression analysis.Age(OR:1.051,95%CI:1.001-1.104),fire-stasis syndrome(OR:23.738,95%CI:3.083-182.782)were the causes of carotid artery stenosis.The logistic regression equation was Y=-6.579+0.05X1+3.167X3.Conclusion:1.In patients with hypertension,gender,smoking,diabetes mellitus,dyslipidemia,coronary heart disease,blood sugar,homocysteine,prothrombin time,carotid intima-media thickness,stenosis and fire-stasis syndrome may be related to the occurrence of acute cerebral infarction.The higher the level of homocysteine,the thicker the carotid intima-media thickness,the more likely the occurrence of acute cerebral infarction.Acute cerebral infarction is more likely to occur in patients with arterial stenosis and syndrome of fire and blood stasis.2.Fire-stasis syndrome in patients with hypertension complicated with acute cerebral infarction may be related to carotid plaque and stenosis.3.In patients with hypertension and acute cerebral infarction,carotid stenosis may be related to age,blood sugar and fire-blood stasis syndrome.The older the patient is,the more likely the carotid artery is to be stenosed.In patients with fire-blood stasis syndrome,the more likely the carotid artery is to be stenosed. |
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