摘要
目的:探讨闭塞性动脉硬化症中医证型与MSCTA影像学表现的相关性,以期为闭塞性动脉硬化症中医辩证提供客观依据,更好的指导临床诊断治疗。
方法:纳入45例诊断为闭塞性动脉硬化症并行MSCTA检查的病人,其中中医辨证为血瘀型27例,湿热下注型18例。将获得的动脉期轴位图像数据结合多种后处理图像对扫描范围内动脉节段及相应的观察指标进行分析,并进行统计分析,探讨闭塞性动脉硬化症中医辨证血瘀及湿热下注两证型与MSCTA影像学表现的相关性。
结果:闭塞性动脉硬化症中医证型与MSCTA影像学表现的相关性:髂外动脉双侧血管钙化、髂外动脉双侧管壁增厚、股总动脉双侧管壁增厚、髂总动脉双侧血管狭窄、股深动脉血管狭窄及双侧股深动脉狭窄、腘动脉血管狭窄、髂内动脉血管闭塞及双侧髂内动脉闭塞、股深动脉血管闭塞及单侧股深动脉闭塞、腹主动脉管腔充盈缺损、股深动脉多发钙化的MSCTA表现以湿热下注型为主,血瘀型患者多无上述表现;髂内动脉单侧血管狭窄的MSCTA表现以血瘀型为主,湿热下注型患者多无单侧髂内动脉血管狭窄的MSCTA表现。
结论:闭塞性动脉硬化症中医辨证血瘀型及湿热下注型两个分型与MSCTA影像学表现存在一定的相关性,血瘀型与湿热下注型两个证型在MSCTA表现上存在一定差别,研究结果可以为闭塞性动脉硬化症的中医辨证论治提供一定的客观依据。
Objective: To study the correlation of ASO between TCM type of syndrome and MSCTA findings. In order to offer proofs for the syndrome differentiation and better guide the clinical diagnosis and treatment. Methods: There were total 45 cases which were definitely diagnosed of ASO and taken MSCTA scans, including 27 cases of blood stasis type and 18 ones of damp-heat invading lower Jiao type. The images acquired by post processing with applicable techniques combined with axial ones were analyzed according to the artery segments and observed indexes. Then the data were analyzed by statistics. Results: The correlation between TCM type of syndrome and MSCTA findings: The findings mainly appeared in damp-heat invading lower Jiao type as follows: calcification of bilateral external iliac artery, wall thickening of bilateral external iliac artery and bilateral common femoral artery, vessel stenosis of common iliac artery, vessel stenosis of deep femoral artery overall and bilateral, vessel stenosis of popliteal artery, vessel obstruction of internal iliac artery overall and bilateral, vessel obstruction of deep femoral artery overall and unilateral, filling defect of abdominal aorta, multiple calcification of deep femoral artery. There were seldom such findings displayed on images of blood stasis type. Vessel stenosis of unilateral internal iliac artery was showed on images of blood stasis type, while it was not for damp-heat invading lower Jiao type. Conclusion: There was certain correlation between TCM type of syndrome and MSCTA findings. There were distinguished MSCTA findings between blood stasis type and damp-heat invading lower Jiao type. The results could be adopted to offer the proofs for TCM syndrome differentiation.
引文
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