基于虚拟组织声像的冠心病痰瘀证候与冠脉斑块特征性研究  

Characteristic Study on Syndromes of Phlegm and Blood Stasis in Coronary Heart Disease and Coronary Plaque Based on the Virtual Histology Intravascular Ultrasound Imaging

作　　者：胡丽娜[1] 王侠[1] 娄田田 HU Li'na;WANG Xia;LOU Tiantian

机构地区：[1]广州中医药大学第二临床医学院(广东省中医院)

出　　处：《新中医》2018年第12期56-59,共4页New Chinese Medicine

基　　金：2014年岭南中医学术流派临床研究专项(YN2014CN06)

摘　　要：目的:通过虚拟组织学-血管内超声(VH-IVUS)技术对痰证、血瘀证、痰瘀互结证和非痰瘀证冠脉斑块进行分析,探讨冠脉斑块和中医学痰浊、血瘀等病理因素之间的相关性。方法:将中医辨证分型为痰证(10例)、血瘀证(10例)、痰瘀互结证(10例)和非痰瘀证(10例)的冠心病的患者共40例,根据不同证型分为4组,应用VH-IVUS影像定量分析不同证型间坏死核心(NC)、钙化部分(DC)、纤维脂质成分(FF)和纤维成分(FI)分布的差异。结果:痰证、血瘀证患者NC水平明显高于痰瘀互结证(P <0.05),痰证、血瘀证和痰瘀互结证患者FF水平明显高于非痰瘀证(P <0.05),痰瘀互结证患者FF水平又明显高于痰证和血瘀证,差异均有统计学意义(P <0.05)。其他证型间NC、DC、FF、FI两两比较,差异均无统计学意义(P> 0.05)。结论:痰浊或血瘀均可增加冠脉斑块FF的含量,且二者同时作用于机体时增加FF的效果明显优于其中一种单因素的效果。Objective:To analyze coronary plaques with phlegm syndrome, blood stasis syndrome, syndrome of intermingled phlegm and blood stasis and non-phlegm-stasis syndrome via virtual histology-intravascular ultrasound (VH-IVUS) technique, and to discuss the correlation between coronary plaque and such pathological factors as turbid phlegm and blood stasis in Chinese medicine. Methods:40 cases of patients with coronary heart disease were divided into the groups of phlegm syndrome,blood stasis syndrome, syndrome of intermingled phlegm and blood stasis and non-phlegm-stasis syndrome according to Chinese medicine syndrome differentiation, 10 cases in each group. Conducted quantitative analysis of the distribution differences in necrotic core (NC), dense calcium(DC),fibro-fatty(FF) and fibre(FI) among different syndrome types in the four groups by means of VH-IVUS imaging. Results: The level of NC in the phlegm group and the blood stasis group was significantly higher than that in the group of intermingled phlegm and blood stasis syndrome(P<0.05). The level of FF in the phlegm group,the blood stasis group and the group of intermingled phlegm and blood stasis syndrome was significantly higher than that in the non-phlegm-stasis group(P<0.05);the level of FF in the group of intermingled phlegm and blood stasis syndrome was significantly higher than that in the phlegm group and the blood stasis group, differences being significant(P<0.05). There were no significant differences being found in the pairwise comparison of levels of NC, DC,FF,FI in the groups of other syndrome types(P>0.05). Conclusion:Phlegm or blood stasis can increase the content of FF in coronary plaque, and under the simultaneous effect of both factors, the increase in the content of FF is evidently higher than that influenced by the single factor.

关 键 词：冠心病 冠脉斑块 虚拟组织学-血管内超声 纤维脂质成分 痰浊 血瘀 

分 类 号：R541.4[医药卫生—心血管疾病]