急性冠脉综合征冠脉病变与中医证型的相关性分析

Correlation Analysis of Acute Coronary Syndrome with Coronary Artery Lesion and TCM Syndromes

目的比较急性冠脉综合征(ACS)不同中医证型的血管内超声(IVUS)特征。方法纳入行IVUS检查的ACS患者66例,按中医辨证分为热毒血瘀证组(36例)和非热毒血瘀证组(30例)。采用IVUS测定2种罪犯病变斑块面积、外弹力膜(EEM)面积、斑块负荷、高危斑块发生率、正向重构、负向重构和重构指数(RI)等指标,使用SPSS软件包,对比分析2种资料。结果热毒血瘀证组罪犯病变处的斑块面积、EEM面积和斑块负荷、高危斑块发生率均显著大于非热毒血瘀证组(P<0.01),重构指数(RI)也高于非热毒血瘀证组(P<0.05);正重构更常见于热毒血瘀证组(P<0.01),负重构常见于非热毒血瘀证组(P<0.01)。结论热毒血瘀证组患者的冠状动脉粥样硬化斑块具有更高的易损性。

OBJECTIVE To compare the characteristics of intravascular ultrasound in diverse TCM types of acute coronary syndrome（ACS）. METHODS 66 patients diagnosed with ACS via IVUS were divided into group of toxic heat and blood stasis syndrome（NHST group with 36 cases） and the group pf non-toxic heat and blood stasis syndrome（Non-NHST group with 30 cases） based on syndrome differentiation. The indexes such as plaque area in criminal lesions, the area of extra-elasticity mem- brane（EEM）, plaque burden, the incidence of high risk plaques, the positive or negative remodeling percentage and remodeling index（RI） were measured by IVUS. Analysis was performed by statistical package SPSSll. 0, with the data being compared. RESULTS The plaque area in criminal lesions, the area of EEM and plaque burden in NHST group were significantly larger than those in Non-NHST group（P 〈0.01） respectively. The incidence of high risk plaques and RI in NHST group were markedly higher than those in Non-NHST group（P〈0.05） respectively. More positive remodeling was observed in NHST group（P〈0.01） while more negative remodeling was seen in Non-NHST group（P〈0.01）. CONCLUSION The coronary ar- terial atherosclerotic plaques in patients with NHST maybe more unstable.