基于冠状动脉CT血管造影的痰瘀热互结型冠状动脉临界病变易损斑块特征研究  

Characteristics Study on Vulnerable Plaques in Borderline Coronary lesion of Binding of Phlegm,Stasis and Heat Type Based on Coronary CT Angiography

作　　者：王文茜[1,2] 王阶[1,3] 张振鹏[3] 方霁[4] 赵青 徐良洲[2] WANG Wenqian;WANG Jie;ZHANG Zhenpeng;FANG Ji;ZHAO Qing;XU Liangzhou

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]武汉市中医医院,湖北武汉430014 [3]中国中医科学院广安门医院,北京100053 [4]中国科学院广州生物医药与健康研究院公共健康研究所,广东广州510530

出　　处：《新中医》2021年第22期44-48,共5页New Chinese Medicine

基　　金：中央级公益性科研院所基本科研业务费专项(Z210-013)。

摘　　要：目的:以冠状动脉CT血管造影(CTA)为评价标准,观察痰瘀热互结型冠状动脉临界病变易损斑块的特征,为冠状动脉临界病变中西医结合诊疗提供客观依据。方法:冠心病痰瘀热互结证采用中医量化标准分值评定,进行CTA显示冠状动脉狭窄程度为30%~70%的病例,分析其CTA指标,包括斑块定位、斑块面积狭窄程度、斑块直径狭窄程度、目标斑块体积等,评估易损斑块特征。结果:冠状动脉临界病变痰瘀热互结证患者易损斑块特征如下:斑块面积狭窄程度(52.25±14.49)%,斑块直径狭窄程度(41.56±11.09)%,斑块体积(65.31±36.05)mm^(3),斑块平均CT值(252.81±155.76)HU;斑块钙化积分[31.40(8.15,101.90)]分。中医证候痰证积分与斑块直径狭窄程度成正相关。结论:痰瘀热互结型冠状动脉临界病变易损斑块经CTA诊断狭窄度更接近于30%;痰瘀热互结型冠状动脉临界病变患者,其痰证积分越高,提示狭窄程度越明显。Objective:Taking coronary CT angiography(CTA)as the evaluation standard,to observe the characteristics of vulnerable plaques in borderline coronary lesion of binding of phlegm,stasis and heat type,so as to provide an objective basis for the integrated Chinese and western medicine diagnosis and treatment of borderline coronary lesion.Methods:The binding of phlegm,stasis and heat syndrome of coronary heart disease was evaluated by scores of quantitative standard of Chinese medicine.CTA was carried out to show the cases with the degree of coronary artery stenosis of 30%to 70%,whose CTA indexes were analyzed,including plaque location,plaque area stenosis,plaque diameter stenosis,and target plaque volume to evaluate the characteristics of vulnerable plaques.Results:The characteristics of vulnerable plaques in patients with borderline coronary lesion with binding of phlegm,stasis and heat syndrome were as follows:the degree of plaque area stenosis was(52.25±14.49)%,the degree of plaque diameter stenosis was(41.56±11.09)%,the volume of target plaque was(65.31±36.05)mm3,and the average CT value of target plaque was(252.81±155.76)HU:target plaque calcification score was[31.40(8.15,101.90)]points.Chinese medicine syndrome scores of phlegm is positively correlated with the degree of plaque diameter stenosis.Conclusion:The degree of stenosis of vulnerable plaques in intermediate coronary stenosis with binding of phlegm,stasis and heat syndrome is closer to 30%by CTA.For the patients with borderline coronary lesion of binding of phlegm,stasis and heat type,the higher the scores of phlegm syndrome,the more obvious the degree of stenosis.

关 键 词：冠状动脉临界病变 痰瘀热互结证 冠状动脉CT血管造影 易损斑块 狭窄程度 痰证积分 

分 类 号：R543.5[医药卫生—心血管疾病]