冠状动脉CTA钙化斑块与冠心病中医证候要素的相关性研究

徐彧，陈正光，赵天佐，袁晓佳，张贺诚，刘悦

（1.北京中医医院顺义医院科研处，北京101300；2.北京中医药大学东直门医院放射科，北京100701）



冠状动脉CTA钙化斑块与冠心病中医证候要素的相关性研究

徐彧1，陈正光2，赵天佐2，袁晓佳2，张贺诚2，刘悦2

（1.北京中医医院顺义医院科研处，北京101300；2.北京中医药大学东直门医院放射科，北京100701）

目的：分析冠状动脉CTA冠状动脉钙化积分、管腔狭窄情况、斑块钙化形态，以及三者与中医证候要素的相关性，为中西医结合预防和治疗冠心病提供理论和临床方面的依据。方法：以60例冠心病为研究对象，统计冠状动脉CTA的冠状动脉钙化积分、管腔狭窄程度，分析斑块钙化形态，对患者行中医证候要素辨识；探讨冠状动脉CTA收集指标与血瘀、气虚、痰浊、阴虚、气滞、阳虚、寒凝7个中医证候要素的关系。结果：血瘀患者的总钙化积分、总斑块数最高；血瘀、寒凝、阴虚、阳虚的血管钙化程度较重，痰浊、气虚的钙化程度较轻；血瘀与总钙化积分、斑块数量、钙化程度呈正相关；痰浊与总钙化积分、斑块数量、钙化程度呈负相关。结论：中医证候要素与冠状动脉CTA的部分指标具有相关性，血瘀对于冠心病的影响重大，阳虚亦不可忽视。此研究结果可为中西医结合预防和治疗冠心病提供研究理论和临床方面的依据。

斑块数量；钙化积分；冠心病；冠状动脉CTA；证候要素

［Abstract］Objective：This study focused on the relationship between the calcified plaque and stenosis situation in the coronary artery calcification score by coronary CTA and TCM syndromes elements，and provided the basis of theoretical and clinical aspects in preventing and curing coronary heart disease with traditional Chinese medicine and western medicine.Methods：this study collected the information of 60 patients diagnosed with coronary artery disease using coronary CTA diagnosis in Beijing University of Chinese Medicine，Dongzhimen Hospital，Department of Radiology，including the coronary CTA coronary artery calcification score，stenosis degree of coronary artery and calcification plaque morphology.Then these coronary CTA collected indexes were compared with seven TCM syndrome elements，namely，blood stasis，qi asthenia，turbid phlegm，yin deficiency，qi stagnation，yang deficiency，and cold coagulation.Results：Blood stasis was the main syndrome factor.The total calcification score and plaque volume of blood stasis patients were the highest.The degree of vascular calcification was heavier in patients of blood stasis，cold coagulation，yin deficiency and yang deficiency；which was lighter in patients of turbid phlegm and qi asthenia.Blood stasis was positive correlated with total calcium score，number of patches and degree of calcification，while turbid phlegm was negative correlated with the three parameters.Conclusion：By the analysis of TCM syndrome elements and coronary CTA results including calcification score，calcification degree and plaque situation，a conclusion is drawn that some of the indexes in coronary CTA are related to TCM syndrome elements.Blood stasis is the major impact factor of coronary heart disease and yang also cannot be ignored.This study could provide theoretical and clinical research evidence for the prevention and treatment of coronary heart disease by integrative medicine.

［Key words］Plaque volume；Calcification score；Coronary artery disease；Coronary CT angiography；Syndromes elements

冠状动脉粥样硬化性心脏病（简称冠心病），中医称之为胸痹。从西医角度来说冠心病是由于冠状动脉血管内膜脂类堆积、管壁弹性减退导致管腔阻塞、狭窄，或由于冠状动脉痉挛导致的心肌缺血、缺氧或坏死，进而引发心脏病，又可称之为缺血性心脏病。……