回归分析闭塞性动脉硬化症中医证型与下肢动脉MSCTA的相关性

Correlation research of arteriosclerosis obliterans Chinese medicine type of syndrome and MSCTA with logistic regression analysis

目的:探讨闭塞性动脉硬化症(ASO)血瘀型与湿热下注型在MSCTA上的特征及其区别。方法:随机收集我院确诊为ASO患者98例,其中血瘀型70例,湿热下注型28例。分别行下肢动脉MSCTA检查,扫描范围从腹主动脉下段至胫动脉中段,扫描层厚2 mm,螺距2.062 5(4层),图像重建层厚2 mm,间隔1 mm,经VRT、MPR、MIP及轴位图像处理。采用适于多重因素相关性分析的logistic回归法,对2组证型的下肢动脉MSCTA征象进行统计比较。结果:与血瘀型强烈相关的MSCTA征象为:①右侧髂总、髂外动脉混合斑块;②左侧股动脉管壁硬化增厚;③血管闭塞相对较少,单侧常见。与湿热下注型强烈相关的MSCTA征象为:①腹主动脉管壁局限性软化增厚;②右侧髂总动脉管腔中度狭窄,髂外动脉管壁环状软化,股动脉侧支形成,胭动脉管壁局限软化;③左侧股动脉轻度狭窄、闭塞,胭动脉侧支形成;④血管闭塞相对较多,双侧常见。结论:ASO血瘀型与湿热下注型在MSCTA表现上存在一定差别,下肢动脉MSCTA检查可以为ASO的中医辨证论治提供客观依据。

Objective： To investigate the characteristic and distinction of blood stasis type and damp invasion of lower energizer type ASP in MSCTA. Methods： Lower extremity artery of 98 ASP patients including blood stasis type 70 examples and damp invasion of lower energizer type 28 examples were examined with MSCTA, ranging from the lower abdominal aorta to the mid-dle of tibial artery. The slice thickness was 2 mm, pitch was 2. 0625, reconstruction thickness was 2 mm, the interval was 1 mm. Image of VRT, MPR, MIP and the axis ones were processed and statistics with logistic regression analysis. Results： MSCTA signs intensely related with the blood stasis type including： ①right common lilac artery and external lilac artery mix plaques; ②left femoral artery pipe wall harden thickening; ③the vascular occlusions were relatively few, or was common by the one-sided. The damp invasion of lower energizer type intense related MSCTA signs were as follows： ①aorta ventralis wall locally became softened thickening; ②right common iliac artery lumen was moderate narrowed, external iliae artery circularity soften, femoral artery branches formed and popliteal wall locally became thicker and softer; ③left femoral artery was mildly narrowed or occlusion, popliteal artery branches formed; ④the vascular occlusion were relatively more, and two-sided common. Conclusion： There are certain differences between blood stasls and damp invasion of lower energizer type of AS0 in the lower limb artery MSCTA performances, which may provide ASO Chinese medicine diagnosis and treatment the objective basis.