单侧颈动脉狭窄患者一级侧支循环与中医体质相关性  

Correlation between Primary Collateral Circulation and TCM Constitutions in Patients with Unilateral Carotid Stenosis

作　　者：刘霞[1] 甄飞 张蝶 孟繁兴[3] LIU Xia;ZHEN Fei;ZHANG Die;MENG Fanxing(Beijing University of Chinese Medicine,Beijing 100029,China;Tongzhou District of Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101100,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院通州院区,北京101100 [3]北京中医药大学东方医院,北京100078

出　　处：《中国中医药信息杂志》2019年第6期23-27,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：北京中医药大学自主选题(2017-JYB-XS-157)

摘　　要：目的探讨单侧颈动脉不同狭窄程度与一级侧支循环建立的相关性,以及一级侧支循环开放与中医体质分布的关系。方法选取经颈动脉超声、CT血管成像(CTA)确诊的单侧颈动脉狭窄(狭窄率≥50%)患者80例,以北美症状性颈动脉内膜切除试验(NASCET)标准分为中度狭窄组、重度狭窄组及闭塞组。采用磁共振血管造影(MRA)、CTA评估各组一级侧支循环开放类型及例数;所有入组患者分为侧支开放组与无侧支开放组,分析一级侧支循环开放与中医体质的关系。结果 3组一级侧支循环开放比较差异有统计学意义(P<0.05);重度狭窄组与中度狭窄组、闭塞组前交通动脉(ACOA)开放比较,差异有统计学意义(P<0.05);3组后交通动脉(PCOA)开放比较,差异无统计学意义(P>0.05)。一级侧支开放组与无开放组患者体质分布比较差异有统计学意义(P<0.05),平和质患者一级侧支循环建立更好,痰湿质、瘀血质、阴虚质患者开放不良;颈动脉不同狭窄程度与体质分布比较差异无统计学意义(P>0.05)。结论颈动脉狭窄程度与一级侧支循环建立具有相关性,重度狭窄患者一级侧支开放更为多见,尤其是ACOA开放;一级侧支循环的建立与中医体质有密切关系。Objective To explore the correlation between the degree of unilateral carotid artery stenosis and the establishment of primary collateral circulation, and the relationship between the opening of the primary collateral circulation and the distribution of TCM constitutions. Methods Totally 80 patients with unilateral carotid stenosis (stenosis rate ≥50%) diagnosed by carotid ultrasonography and computed tomography angiography (CTA) were divided into three groups: the moderate, the severe stenosis and the occlusion groups according to North American symptomatic carotid endarterectomy trial (NASCET). Magnetic resonance angiography (MRA) and CTA were used to evaluate the type and number of collateral circulations in each group. After all patients were divided into collateral open/closed group, the relationship of primary collateral circulation with TCM constitutions was investigated. Results There was statistical significance in the open rate of primary collateral circulation in three groups (P<0.05);there was statistical significance in the anterior communicating artery (ACOA) open of the severe stenosis group compared with moderate stenosis group and occlusion group (P<0.05);while there was no statistical significance in posterior communicating artery (PCOA) open of the three groups (P>0.05). There was statistical significance in TCM constitution distribution between the open and the closed (P<0.05). The peaceful constitution has better primary collateral circulation, while the patients with constitutions of phlegm dampness, blood stasis and yin deficiency have poor opening. There was no statistical significance in TCM constitution distribution in the three groups (P>0.05). Conclusion The open level of primary collateral circulation is closely correlated with unilateral carotid artery stenosis. The opening ACOA is more common in patients with severe stenosis, especially ACOA open. The opening of the primary collateral circulation is closed related to the distribution of TCM constitutions.

关 键 词：颈动脉狭窄 一级侧支循环 中医体质 大脑动脉环 

分 类 号：R277.748[医药卫生—中医学]