脑卒中中医辨证分型与头颈部CT灌注成像参数的相关性

Correlation between Traditional Chinese Medicine Syndrome Differentiation of Stroke and CT Perfusion Imaging Parameters of Head and Neck

目的:探讨脑卒中中医辨证分型与头颈部CT灌注成像(CTP)参数的相关性。方法:回顾性分析2020年1月~2021年12月本院收治的70例脑卒中患者,所有患者均进行中医辨证分型并接受CT平扫、CTP检查,记录其病灶分布、面积、数量和患侧脑组织与对侧镜相区脑组织的相对脑血容量(rCBV)、相对脑血流量(rCBF)、相对达峰时间(rTTP)、相对平均通过时间(rMTT)等头颈部CTP参数。结果:纳入的70例脑卒中患者以气虚血瘀型(37.14%)和风痰阻络型(30.00%)最为常见。不同脑卒中中医辨证分型患者在半卵圆区和基底节区的病灶分布差异显著(P<0.05),其中半卵圆区病灶多见于气虚血瘀型,基底节区病灶多见于风痰阻络型;不同中医辨证分型脑卒中患者缺血面积、病灶数量差异显著(P<0.05),其中痰热腑实型脑卒中患者病灶面积最大,风痰阻络型脑卒中以多发病灶为主;不同中医辨证分型脑卒中患者rCBV、rCBF、rTTP和rMTT等头颈部CT灌注成像参数差异显著(P<0.05),其中痰热腑实型、风痰阻络表现为rCBV、rCBF降低和rTTP、rMTT延长。结论:脑卒中中医辨证分型与头颈部CTP参数密切相关,头颈部CTP检查可作为脑卒中中医辨证分型的客观影像检查手段。

Objective:To explore the correlation between TCM syndrome differentiation of stroke and CT perfusion(CTP)parameters of head and neck.Methods:A retrospective analysis was performed on the 70 patients with stroke admitted to the hospital between January 2,020 and December 2,021.All underwent examinations of TCM syndrome differentiation,CT plain scan and CTP.The distribution,area and number of lesions,and CTP parameters of head and neck relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),relative time to peak(rTTP),relative mean transit time(rMTT)in brain tissue of affected side and contralateral area were recorded.Results:In the 70 patients with stroke,the main TCM syndromes were Qi-deficiency blood stasis type(37.14%)and wind-phlegm blocking collateral type(30%).There were significant differences in the distribution of lesions in semioval area and basal ganglia among stroke patients with different TCM syndromes(P<0.05).The lesions in semioval area were mainly in patients with Qi-deficiency blood stasis type,while lesions in basal ganglia were mainly in patients with wind-phlegm blocking collateral type.There were significant differences in ischemic area and number of lesions among stroke patients with different TCM syndromes(P<0.05).The area of lesions was the largest in patients with phlegm-heat Fu stagnation type,and multiple lesions were mainly in patients with wind-phlegm blocking collateral type(P<0.05).There were significant differences in CTP parameters of head and neck(rCBV,rCBF,rTTP,rMTT)among stroke patients with different TCM syndromes(P<0.05).The rCBV and rCBF were decreased,rTTP and rMTT were prolonged in patients with phlegm-heat Fu stagnation type and wind-phlegm blocking collateral type.Conclusion:TCM syndrome differentiation of stroke is closely related to CTP parameters of head and neck.CTP examination of head and neck can be applied as an objective imaging method for TCM syndrome differentiation of stroke.