CTA评估下肢动脉硬化闭塞症不同中医证型形态学改变的价值

Evaluation value of CTA to the morphological changes of arteriosclerosis obliterans with different TCM syndrome types

目的:探讨CTA评估下肢动脉硬化闭塞症(ASO)不同中医证型形态学改变的价值。方法:选取ASO患者200例,其中血瘀型111例,湿热下注型89例,分别行CTA检查,扫描范围从腹主动脉肾动脉开口层面至足背动脉,扫描后图像传至工作站行MPR,测量并比较2组腹主动脉下段、双侧髂总动脉、双侧髂外动脉、双侧股总动脉、双侧股浅动脉、双侧腘动脉血管管壁及管腔情况。结果:湿热下注型患者闭塞血管节段发生率及双侧血管闭塞发生率均高于血瘀型,差异均有统计学意义(均P<0.05)。按照血管部位发生率,湿热下注型中腹主动脉、髂总动脉、股总动脉略高于血瘀型,血瘀型中髂外动脉、股浅动脉、腘动脉均略高于湿热下注型,但其差异均无统计学意义(均P>0.05)。结论:ASO患者各中医证型的形态学改变存在一定差别,可以此对其进行初步的鉴别。

Objective:To explore the value of CTA in evaluating the morphological changes of different TCM syndrome types of arteriosclerosis obliterans(ASO).Methods:A total of 200 ASO patients were enrolled,including 111 cases of blood stasis type and 89 cases of downward flow of dampness heat type.Everyone was examined by CTA.The scanning range was from the level of the opening in renal artery to the dorsalis pedis artery.After scanning,the images were transported to the workstation,which were used for MPR.The lumen diameter of the far-end of abdominal aorta,bilateral common iliac arteries,bilateral external iliac arteries,bilateral common femoral arteries,bilateral superficial femoral arteries and bilateral popliteal arteries were measured and compared statistically.Results:The incidence of occluded vascular segments and bilateral vascular occlusion in the patients with down ward flow of dampness heat type were higher than those in the patients with blood stasis type(both P<0.05).According to the incidence of blood vessels,the location in abdominal aorta,common iliac artery and common femoral artery of the type of dampness heat syndrome were mild higher than those of blood stasis,and the location in the external iliac artery,superficial femoral artery and popliteal artery of the type of blood stasis was mild higher than those of dampness heat,but the differences were not statistically significant(all P>0.05).Conclusion:There are some differences among TCM syndromes in ASO patients,which could be used for preliminary identification.