颈内动脉钙化积分与缺血性中风急性期中医证型的相关性研究

Study on Correlation Between Internal Carotid Artery Calcification Score and Chinese Medicine Syndromes in Acute Stage of Ischemic Stroke

目的:探讨颈内动脉Agatston钙化积分与缺血性中风急性期中医证型的相关性。方法:将400例缺血性中风急性期患者按照中医辨证分为风痰火亢、风火上扰、痰热腑实、风痰瘀阻、痰湿蒙神、气虚血瘀、阴虚风动等7个证型;所有病例均行Siemens双源头颈CT检查,计算颈内动脉Agatston钙化积分,并根据积分划分为0分、1199分、200399分、400599分及≥600分5个等级;比较缺血性中风急性期各中医证型患者的颈内动脉钙化积分情况。结果:缺血性中风急性期各中医证型患者在年龄、性别方面比较,差异无统计学意义(P>0.05)。共有328例患者存在颈内动脉钙化,各证型患者所占例数从多到少依次为:风痰瘀阻证>气虚血瘀证>阴虚风动证>痰热腑实证>风火上扰证>风痰火亢证>痰湿蒙神证。各中医证型患者颈内动脉钙化积分比较,差异有统计学意义(P<0.05);各证型的颈内动脉钙化积分级比较,差异无统计学意义(P>0.05)。结论:缺血性中风急性期中医证型中分布风痰瘀阻证及气虚血瘀证占比较多;各中医证型颈内动脉钙化积分存在一定差异,以气虚血瘀证积分最高、风痰瘀阻证次之,此可为缺血性中风急性期中医辨证分型的研究提供参考。

Objective:To investigate the correlation between Agatston calcification score of internal carotid artery and Chinese medicine syndromes in acute stage of ischemic stroke.Methods:According to the Chinese medicine syndrome differentiation,400 patients with acute ischemic stroke were divided into seven syndrome types:fire hyperactivity of windphlegm,wind-fire harassing the upper body,phlegm-heat and bowel excess,wind-phlegm stasis obstruction,phlegmdamp clouding the spirit,qi deficiency and blood stasis,and stirring of wind due to yin deficiency.All patients underwent Siemens double-source head and neck CT examination,and Agatston calcification score of internal carotid artery was calculated,which was divided into five grades:0,1-199,200-399,400-599 and ≥600.The calcification scores of internal carotid artery in patients with different Chinese medicine syndromes in acute stage of ischemic stroke was compared.Results:There was no significant difference in the comparison of the age and sex among patients with different Chinese medicine syndromes in acute stage of ischemic stroke.A total of 328 patients had internal carotid artery calcification,and the number of patients with various syndromes was from most to least:syndrome of wind-phlegm stasis obstruction,syndrome of qi deficiency and blood stasis,syndrome of stirring of wind due to yin deficiency,syndrome of phlegm-heat and bowel excess,syndrome of wind-fire harassing the upper body,syndrome of fire hyperactivity of wind-phlegm,syndrome of phlegm-damp clouding the spirit.The scores of internal carotid artery calcification in patients with different Chinese medicine syndromes were compared,the difference being significant(P<0.05).There was no significant difference in the scores of internal carotid artery calcification among different syndromes(P>0.05).Conclusion:The syndrome of windphlegm stasis obstruction and the syndrome of qi deficiency and blood stasis are the most common syndromes in acute stage of ischemic stroke.The scores of internal carotid artery calcification are different among different Chinese medicine syndromes.The score of the syndrome of qi deficiency and blood stasis is the highest,followed by syndrome of windphlegm stasis obstruction,which can provide reference for the study of Chinese medicine syndrome differentiation and classification of acute ischemic stroke.