中国中医急症2025，Vol.34Issue(6)：946-950,983,6.DOI:10.3969/j.issn.1004-745X.2025.06.002
急性脑梗死并发全身炎症反应综合征患者中医证候及相关危险因素分析
Analysis of Traditional Chinese Medicine Syndromes and Related Risk Factors in Patients with Acute Cerebral Infarction Complicated with Systemic Inflammatory Response Syndrome
摘要
Abstract
Objective:To investigate the characteristics of traditional Chinese medicine(TCM)syndromes and analyze the related risk factors in patients with acute cerebral infarction(ACI)complicated with systemic inflamma-tory response syndrome(SIRS).Methods:A retrospective case-control study was conducted on patients admitted to the emergency department of Dongzhimen Hospital from January 2018 to February 2023.Patients were divided into two groups:simple ACI group(SACI group)and ACI complicated with SIRS group(SIRS group).TCM syn-dromes and related risk factors were compared between the two groups.Results:A total of 353 cases were ana-lyzed(333 in SACI group,20 in SIRS group),with a SIRS incidence rate of about 5.67%.Among them,8 patients died,and the mortality rate within 30 days after onset in the SIRS group was significantly higher than that in the non-SIRS group(P<0.05).Of 188 cases with definite infarction location(176 in SACI group,12 in SIRS group),different sizes of cerebral infarction had different rates of secondary SIRS.The proportions of blood stasis syn-drome and phlegm-dampness syndrome were both more than 50%in the two groups,while the proportion of qi de-ficiency syndrome was significantly higher in the SIRS group than in the SACI group(P<0.05).Univariate analy-sis showed that age,white blood cell count,neutrophil count,platelet count,C-reactive protein,procalcitonin,prothrombin time,fibrinogen levels,D-dimer,international normalized ratio,initial random blood glucose at admis-sion,creatinine,urea,aspartate aminotransferase,total bilirubin,total cholesterol,low-density lipoprotein,high-den-sity lipoprotein,history of atrial fibrillation,etc.,were statistically significant between the two groups.Multivariate logistic regression analysis revealed that history of atrial fibrillation(OR=17.503,95%CI:1.636-187.303,P=0.018),white blood cell count(OR=1.678,95%CI:1.106-2.545,P=0.015),and total bilirubin(OR=1.181,95%CI:1.025-1.360,P=0.022)were independent risk factors for SIRS in patients with cerebral infarction.Conclusion:The mortality rate is relatively high and prognosis is poor in patients with ACI complicated with SIRS.Large or multiple cerebral infarctions are more likely to be complicated with SIRS.Blood stasis syndrome and phlegm-dampness syndrome are present regardless of whether SIRS occurs,while qi deficiency syndrome is more common in the SIRS group.History of atrial fibrillation,white blood cell count,and total bilirubin are independent risk fac-tors for SIRS occurrence.关键词
急性脑梗死/全身炎症反应综合征/危险因素/中医证候Key words
Acute cerebral infarction/Systemic inflammatory response syndrome/Risk factors/TCM syndromes分类
医药卫生引用本文复制引用
张米镎,于潇杰,李玉峰,王双玲,刘清泉..急性脑梗死并发全身炎症反应综合征患者中医证候及相关危险因素分析[J].中国中医急症,2025,34(6):946-950,983,6.基金项目
中央高校基本科研业务费专项资金(2023-JYB-XJSJJ-028) （2023-JYB-XJSJJ-028）
北京市通州区科技计划项目(KJ2023CX057) （KJ2023CX057）
国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023001) （zyyzdxk-2023001）
