不同中医证型脑梗死患者颈动脉斑块的超声造影分析
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摘要
目的研究不同回声类型颈动脉斑块及不同中医证型脑梗死患者颈动脉斑块的超声造影表现。方法随机选取74例脑梗死患者的121个颈动脉斑块,行超声造影检查,按斑块的不同回声类型和患者的不同中医证型分类,进行分析。结果稳定斑块(造影Ⅰ级)以高回声斑块为最主要类型,不稳定型斑块(造影Ⅱ级和Ⅲ级)以低回声斑块比例最高;稳定斑块(造影Ⅰ级)以阴虚阳亢为最主要证型,不稳定斑块(造影Ⅱ级和Ⅲ级)风痰瘀阻和风痰火亢的检出率明显高于阴虚阳亢,有统计学意义。结论通过分析不同中医证型脑梗死患者及不同回声类型颈动脉斑块超声造影分级表现,总结规律,对不同中医证型脑梗死的诊断和治疗提供客观指标。
Objective To study the ultrasound contrast of carotid plaques in cerebral infarction patients with different echo-type carotid plaques and different traditional Chinese medicine syndromes. Methods A total of 121 carotid artery plaques in 74 patients with cerebral infarction were randomly selected,and ultrasound contrast was performed to analyze the different types of echo and different traditional Chinese medicine syndromes of the patients. Results High echo plaques were the most important types of stable plaques( imagingⅠlevel),and unstable plaques( imaging Ⅱ and Ⅲ level) had the highest proportion of low-echo plaques. Stable plaques( imaging Ⅰlevel) in the yin deficiency and yang excess as the main syndrome types. The detection rate of unstable plaques( imaging Ⅱ and Ⅲ level) wind phlegm and blood stasis resistance and wind phlegm fire was significantly higher than yin deficiency hyperactivity of yang. Conclusion By analyzing the different traditional Chinese medicine syndrome types and carotid plaques contrast-enhanced ultrasound echo type classification,this paper summarizes rules for the diagnosis and treatment of cerebral infarction patients with different traditional Chinese medicine syndrome types.
Objective To study the ultrasound contrast of carotid plaques in cerebral infarction patients with different echo-type carotid plaques and different traditional Chinese medicine syndromes. Methods A total of 121 carotid artery plaques in 74 patients with cerebral infarction were randomly selected,and ultrasound contrast was performed to analyze the different types of echo and different traditional Chinese medicine syndromes of the patients. Results High echo plaques were the most important types of stable plaques( imagingⅠlevel),and unstable plaques( imaging Ⅱ and Ⅲ level) had the highest proportion of low-echo plaques. Stable plaques( imaging Ⅰlevel) in the yin deficiency and yang excess as the main syndrome types. The detection rate of unstable plaques( imaging Ⅱ and Ⅲ level) wind phlegm and blood stasis resistance and wind phlegm fire was significantly higher than yin deficiency hyperactivity of yang. Conclusion By analyzing the different traditional Chinese medicine syndrome types and carotid plaques contrast-enhanced ultrasound echo type classification,this paper summarizes rules for the diagnosis and treatment of cerebral infarction patients with different traditional Chinese medicine syndrome types.
引文
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[3]Müller HF,Viaccoz A,Kuzmanovic I,et al.Contrast-enhanced ultrasound imaging of carotid plaque neo-vascularization:accuracy of visual analysis[J].Ultrasound Med Biol,2014,40(1):18-24
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[8]韩燕妮,钟洁愉,董理聪,等.超声造影评价瑞舒伐他汀与阿托伐他汀对颈动脉斑块新生血管的影响[J].临床超声医学杂志,2017,19(6):395-398
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[13]李超伦,王文平,何婉媛,等.不同回声类型颈动脉斑块超声造影增强强度的分析[J].中华医学超声杂志(电子版),2012,9(12):1052-1056
[14]王敬卿,叶丽红.高脂血症、动脉粥样硬化、脑梗死的相关性-周仲瑛教授老年医学学术思想探讨[J].中国医药学报,2004,19(11):672-674
[15]张颖.彩色多普勒超声在颈动脉粥样硬化中医辨证分型临床应用价值[J].辽宁中医药大学学报,2018,20(2):196-199
[16]王平平,高利.颈动脉粥样硬化的中西医结合研究进展[J].中国中西医结合急救杂志,2007,14(2):125-128
[17]杨晓妮,李长生,刘晓明.动脉硬化性脑梗死中医证型与颈动脉超声征象的相关性研究[J].江苏中医药,2011,43(10):17-19
[18]杨利,黄燕,蔡业峰,等.1418例中风患者痰瘀证候分布和演变规律探析[J].辽宁中医杂志,2004,31(6):459-460
[19]戴旭辉,余晓梅,梅芳,等.脑梗死患者颈动脉粥样斑块与中医证型的相关性分析[J].现代中西医结合杂志,2014,23(25):2781-2782
[2]国家中医药管理局脑病急症科研组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56
[3]Müller HF,Viaccoz A,Kuzmanovic I,et al.Contrast-enhanced ultrasound imaging of carotid plaque neo-vascularization:accuracy of visual analysis[J].Ultrasound Med Biol,2014,40(1):18-24
[4]余海歌,何文,张东,等.多模态超声评价颈动脉斑块易损性的多因素分析[J].中国卒中杂志,2018,13(9):922-927
[5]Zhang H,Du J,Wang H,et al.Comparison of diagnostic values of ultrasound micro-flow imaging and contrast-enhanced ultrasound for neovascularization in carotid plaques[J].Exp Ther Med,2017,14(1):680-688
[6]戴旭辉,余晓梅,苏曼莉.颈部彩超联合TCD对颈动脉支架置入的随访观察[J].医疗卫生装备,2017,38(2):86-88
[7]戴旭辉,梅芳,余晓梅,等.单侧颈内动脉狭窄患者支架置入前后脑血管储备能力变化分析[J].安徽医学,2015,36(12):1454-1456
[8]韩燕妮,钟洁愉,董理聪,等.超声造影评价瑞舒伐他汀与阿托伐他汀对颈动脉斑块新生血管的影响[J].临床超声医学杂志,2017,19(6):395-398
[9]徐斌,张丹,刘兴洲,等.对颈动脉粥样硬化溃疡斑块内超声造影的定量研究[J].中国卒中杂志,2010,5(11):899-903
[10]Ritter MA,Theismann K,Schmiedel M,et al.Vascularization of carotid plaque in recently symptomatic patients is associated with the occurrence of transcranial microembolic signals[J].Eur J Neurol,2013,20(8):1218-1221
[11]Staub D,Partovi S,Schinkel AF,et al.Correlation of carotid artery atherosclerotic lesion echogenicity and severity at standard US with intraplaque neovascularization detected at contrast-enhanced US[J].Radiology,2011,258(2):618-626
[12]陈娜燕,朱建平,周初勋,等.超声造影对不同回声类型颈动脉斑块内新血管的分析[J].中国动脉硬化杂志,2016,24(11):1109-1114
[13]李超伦,王文平,何婉媛,等.不同回声类型颈动脉斑块超声造影增强强度的分析[J].中华医学超声杂志(电子版),2012,9(12):1052-1056
[14]王敬卿,叶丽红.高脂血症、动脉粥样硬化、脑梗死的相关性-周仲瑛教授老年医学学术思想探讨[J].中国医药学报,2004,19(11):672-674
[15]张颖.彩色多普勒超声在颈动脉粥样硬化中医辨证分型临床应用价值[J].辽宁中医药大学学报,2018,20(2):196-199
[16]王平平,高利.颈动脉粥样硬化的中西医结合研究进展[J].中国中西医结合急救杂志,2007,14(2):125-128
[17]杨晓妮,李长生,刘晓明.动脉硬化性脑梗死中医证型与颈动脉超声征象的相关性研究[J].江苏中医药,2011,43(10):17-19
[18]杨利,黄燕,蔡业峰,等.1418例中风患者痰瘀证候分布和演变规律探析[J].辽宁中医杂志,2004,31(6):459-460
[19]戴旭辉,余晓梅,梅芳,等.脑梗死患者颈动脉粥样斑块与中医证型的相关性分析[J].现代中西医结合杂志,2014,23(25):2781-2782