Clinical Study Of Relationship Between Zheng Differentiation-Classification Of TCM, Serum Sicam-1 And MDA In Patients With Acute Intracerebral Hemorrhage

Objective: 1. To investigate the changes and significance of serum soluble intercellular adhesion molecule-1 (sICAM-1) and Malondialdehyde (MDA) in patients with acute intracerebral hemorrhage (AICH) ; 2. To study the relationship between the two indexes and zheng differentiation-classification of TCM, the degree of nervous function impairment, The time after onset, the volume of hematoma; 3. To evaluate the correlation between the serum sICAM-1 and MDA in patients with AICH.Methods:The serum concentrations of sICAM-1 and MDA in 80 patients with AICH and 20 healthy controls were measured respectively by two-layer antibody sandwich enzyme-linked immunosorbent assay (ELISA) and thiobarbituric acid (TBA) methods.Results:1. Compared with the control group, the serum concentrations of sICAM-1, MDA in patients with AICH increased significantly (P<0.01); 2. Compared with the control group, the levels of the two indexes increased remarkably in the meridian and collateral apoplexy (including sthenic and deficiency syndromes) group and the viscera apoplexy group (P<0.01); the two indexes levels of the viscera apoplexy group were higher than those of the meridian and collateral apoplexy group(P<0.01); the two indexes levels of the sthenic syndrome group were higher than those of the deficiency syndrome group(P<0.05); 3. The serum levels of sICAM-1 ,MDA of the classified types of TCM based on syndrome differentiation were higher than those of the control group(P<0.01), it was highest in the viscera apoplexy group. The two indexes levels in patients of the viscera apoplexy group were higher than those of the liver-yang excessive rising, wind-phlegm accumulation, qi deficiency with blood stasis , wind formation due to yin deficiency groups(P<0.05,P<0.01). There was remarkable difference in serum sICAM-1 level between the phlegm-heat and bowel stoppage group and the viscera apoplexy group(P<0.05), but none about MDA. Among the meridian and collateral apoplexy groups, the serum levels of sICAM-1, MDA in the phlegm-heat and bowel stoppage group were the highest; there was significant difference between the phlegm-heat and bowel stoppage group and the wind-phlegm accumulation, qi deficiency with blood stasis and wind formation due to yin deficiency groups(P < 0.01). The level of sICAM-1 in the phlegm-heat and bowel stoppage group was higher than that of the liver-yang excessive rising group, but there was no significant difference. About MDA there was significant difference between them(P < 0.05); 4. Compared with the control group, the concentrations of the two indexes all increased significantly in mild , medium , severe type groups(P<0.01); between any two of the three disease groups there was obvious difference(P<0.05,P<0.01). 5. During 72h after onset ,the levels of the indexes in the different time groups were higher than those in the control group, the highest was in 25~48h group, between which and 24h group, 49~72h group there was significant difference(P<0.01,P<0.05). 6. The levels of the indexes in the groups of the different hemorrhagic volume were all higher than those in the control group(P<0.01), remarkable difference of the indexes was found in large and small volume groups(P<0.05,P<0.01). The sICAM-1 level had significant difference between large and moderate groups(P< 0.05), but none about MDA (P>0.05) . 7. There was close positive correlation between serum sICAM-1 and MDA in patients of AICH. 8. In the meridian and collateral apoplexy and the viscera apoplexy groups, there was close positive correlation between the two indexes, the meridian and collateral apoplexy group more significantly. 9. The cumulative points for the illness condition of TCM were positively correlated to the two indexes.Conclusions: 1. The leukocyte adhesion and oxidative stress increased in patients with AICH, the levels of serum sICAM-1 and MDA increased remarkably ; two of them had close relation, were involved in the pathological mechanism of cerebral damage after ICH. 2. Among the syndrome types of TCM , the levels of t...