闭塞性动脉硬化症中医辨证血瘀型与湿热下注型MSCTA表现特征性研究

Respective characteristic study on MSCTA findings of arteriosclerosis obliterans in traditional Chinese medicine type of blood-stasis and damp-heat invading lower Jiao

目的:探讨闭塞性动脉硬化症(ASO)中医辨证血瘀型与湿热下注型多层螺旋CT血管成像(MSCTA)表现的特征性。方法:纳入76例临床诊断为ASO并行MSCTA检查的患者,其中经中医辨证,血瘀型46例,湿热下注型30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相应的动脉节段观察指标进行记录,然后进行统计学分析。结果:湿热下注型与血瘀型MSCTA表现存在显著性差异。湿热下注型MSCTA的表现特征:髂总动脉多表现为血管管腔狭窄和闭塞;髂内动脉多表现为血管管腔闭塞;髂外动脉多表现为血管管壁钙化、增厚和血管管腔狭窄;股总动脉多表现为双侧血管管壁钙化、增厚、血管管腔狭窄;股深动脉多表现为血管管壁钙化、增厚和血管管腔狭窄;股动脉多表现为血管管壁增厚和血管闭塞;腘动脉多表现为血管管壁钙化、增厚和血管管腔狭窄。血瘀型大多缺乏上述MSCTA表现特征。结论:ASO中医辨证血瘀型与湿热下注型具有各自的MSCTA特征性表现,可以为ASO的分型提供一定客观依据。

Objective： To study the respective character of MSCTA findings of ASO in TCM type of blood-stasis and damp-heat invading lower Jiao. Methods： Seventy-six cases with a clinical diagnosis of ASO underwent MSCTA scanning, including 46 cases of blood stasis type and 30 cases of damp-heat invading lower Jiao type. Analyzed the images acquired by post processing with applicable techniques combined with axial ones according to the artery segments and observed indexes. Then the data were analyzed by statistics. Results： The character of MSCTA findings of damp-heat invading lower Jiao： vessel stenosis and obstruction of common iliac artery; vessel obstruction of internal iliac artery overall and bilateral; calcification, wall thickening, vessel stenosis and obstruction of external iliac artery overall and bilateral; calcification of bilateral common femoral artery, wall thickening of overall and bilateral common femoral artery; vessel stenosis of deep femoral artery, calcification and wall thickening of deep femoral artery overall and bilateral; wail thickening of overall and single femoral artery, vessel obstruction of femoral artery overall and bilateral; calcification, wail thickening and vessel stenosis of popliteal artery overall and bilateral. There were seldom such findings displayed on images of blood stasis type. Conclusion： There are distinguished MSCTA findings between blood stasis type and damp-heat invading lower Jiao type. The results can be adopted to offer the proofs for TCM syndrome differentiation.