目的探讨岭南地区冠心病患者中医分型血管内超声显像特点,为冠心病临床治疗提供理论依据。方法对确诊为冠心病,中医诊断为痰浊闭阻型胸痹(27例),气虚血瘀型胸痹(22例),将其血管内超声结果结合患者一般情况按中医诊断型别进行分析对比。结果在冠心病分型方面,两个纳入中医症型患者的患病主要类型均为心肌梗死、心绞痛、缺血性心肌病,其中气虚血瘀型患者心绞痛患病所占比例显著高于痰浊闭阻型患者(P<0.05),而痰浊闭阻型患者心肌梗死所占比例显著高于气虚血瘀型(93%vs. 64%,P<0.01)。痰浊闭阻型胸痹组的血管外弹力膜面积显著大于气虚血瘀型[(16±3) mm^2vs.(13±3) mm^2,P<0.01];痰浊闭阻型胸痹组的斑块面积显著大于气虚血瘀型胸痹组[(11±3) mm^2vs.(9±3) mm^2,P<0.05]。而在斑块负荷、斑块纤维帽厚度、脂质池面积、平均血管直径、斑块偏心指数、斑块厚度和斑块钙化类型相关方面两组差异均无统计学意义。多元线性回归分析提示在斑块面积方面是痰浊闭阻型胸痹患者的独立相关因素(P<0.01)。结论痰浊闭阻型胸痹患者以斑块面积大为主要特征。
AIM To explore the characteristics of intravascular ultrasound imaging of coronary heart disease patients in Lingnan Region and provide a theoretical basis for clinical treatment of coronary heart disease. METHODS The study included 49 patients with coronary heart disease (27 cases of phlegm obstructing chest obstruction and 22 cases of chest obstruction related to Qi deficiency and blood stasis). Intravascular ultrasound results together with the general conditions of the patients were compared between the two groups, according to TCM diagnostic types. RESULTS In the classification of coronary heart disease, the main types included myocardial infarction, angina pectoris, and ischemic cardiomyopathy. The proportion of angina pectoris in patients with Qi deficiency and blood stasis was significantly higher than that in patients with phlegm obstruction (P < 0. 05 ), while the proportion of myocardial infarction in patients with phlegm obstruction was significantly higher than that in patients with Qi deficiency and blood stasis (93% vs. 64%, P < 0. 05 ). The area of extravascular elastic membrane in phlegm turbidity obstruction group was significantly larger than that in Qi deficiency and the blood stasis group [(16 ±3) mm^2 vs.( 13 ± 3) mm^2, P < 0. 05 ] and the plaque area in phlegm turbidity obstmction group was significantly larger than that in the Qi deficiency and blood stasis group [(11 ± 3) mm^2 vs.(9 ± 3) mm^2, P < 0. 05 ]. There was no significant difference in plaque load , plaque fibrous cap thickness, lipid pool area, mean vessel diameter, plaque eccentricity index, plaque thickness, and plaque calcification type between the two groups. Multivariate linear regression analysis showed that the plaque area was an independent correlative factor in patients with obstructive thoracic paralysis due to turbid phlegm (P < 0. 01 ). CONCLUSION The large area of plaque is the main feature of coronary heart disease patients with chest obstruction related to phlegm turbidity blockage.
Chinese Heart Journal
phlegm type obstruction
coronary heart disease
south of the five ridges