| Objective:By collecting the "phlegm heat score" and clinical examination data of patients with unstable carotid atherosclerotic plaque,we explored the relationship between phlegm heat syndrome,carotid plaque,local hemodynamics and risk factors related to carotid plaque.In addition,the blood viscosity,non-invasive endothelial shear force calculation model and TCM syndrome differentiation were applied to clinical observation to find a new perspective for the prevention and treatment of carotid plaque with the combination of Chinese and Western medicine.Method:The patients who meet the diagnosis of phlegm heat syndrome in the phlegm heat scoring scale and those who meet the diagnosis of unstable plaque of carotid atherosclerosis were screened according to the exclusion criteria.The selected patients were classified according to the phlegm heat syndrome score,and the social demographic information(gender,age,etc.),general situation(BMI,etc.),phlegm heat score and other data were recorded at the same time.Subsequently,the required clinical examination data(blood routine,biochemical series,carotid ultrasound,etc.)will be input into the database for statistical analysis.Result:1.With the increase of phlegm heat score,Endothelial Shear Stress(ESS)increased(P<0.05),which was statistically significant.Among them,there was a statistical difference between the phlegm heat grade1 group and the phlegm heat grade 3 group(P<0.05),and there was no statistical difference between the phlegm heat grade 1 group and the phlegm heat grade 2 group,the phlegm heat grade 2 group and the phlegm heat grade 3 group(P>0.05).Blood flow velocity,Blood Viscosity(BV)and vessel radius are three variables in the ESS model.Statistical analysis shows that although the average Peak Systolic Velocity(PSV)and BV of the common carotid artery increase with the increase of phlegm heat score,there is no statistical difference among the three groups(P>0.05).The correlation coefficient between the score of fire heat syndrome and the average diameter of common carotid artery was r=-0.302,which was statistically significant(P<0.05),indicating that there was a negative correlation between the score of fire heat syndrome and the average diameter of common carotid artery;The correlation coefficient between the score of fire heat syndrome and the average PSV of common carotid artery was r=0.301,which was statistically significant(P<0.05),indicating that there was a positive correlation between the score of fire heat syndrome and the average PSV of common carotid artery.2.The ESS of patients with soft spots was higher than that of patients with mixed spots,with a statistically significant difference(P<0.05).The mean diameter of common carotid artery in patients with soft plaque was lower than that in patients with mixed plaque,the difference was statistically significant(P<0.05).3.The Ty G index increased with the increase of phlegm heat score(P<0.05).There was a statistical difference between the phlegm heat grade 1 group and the phlegm heat grade 3 group,between the phlegm heat grade 2 group and the phlegm heat grade 3 group(P<0.05),and there was no statistical difference between the phlegm heat grade 1group and the phlegm heat grade 2 group(P>0.05).The correlation coefficient between phlegm syndrome score and Ty G index is r=0.496,which is statistically significant(P<0.001),indicating that there is a positive correlation between phlegm syndrome score and Ty G index.4.The influence of blood lipid on plaque properties: The Cholesterol(CHOL),Low Density Lipoprotein-Cholesterol(LDL-C),Ty G index and BMI of patients with soft plaque were higher than those of patients with mixed plaque,and the plaque area of patients with soft plaque was smaller than that of patients with mixed plaque,with significant differences(P<0.05).The effect of blood lipid on hemodynamics: CHOL,LDL-C and ESS were significantly positively correlated(P<0.05),and there was no statistical difference between Ty G index and ESS(P>0.05).There was a significant negative correlation between the mean diameter of common carotid artery and CHOL,LDL-C(P<0.05),and a significant positive correlation between BV and Ty G index(P<0.05).5.The correlation coefficient between the average common carotid artery diameter and the average common carotid artery PSV was r=-0.407,which was statistically significant(P<0.001),indicating that there was a negative correlation between the average common carotid artery diameter and the average common carotid artery PSV.6.The correlation coefficient between D-Dimer(D-Di)and ESS is r=-3.50,which is statistically significant(P<0.05),so there is a negative correlation between D-Di and ESS.Conclusion:1.The relationship between phlegm heat syndrome and local hemodynamics of carotid artery can be seen from the comprehensive force of phlegm heat syndrome on carotid artery endothelium-ESS.It can be found that there is a positive correlation between them,that is,the higher the phlegm heat score,the higher the ESS.The study found that phlegm heat syndrome may mainly affect hemodynamics by affecting blood flow velocity and blood vessel diameter.Fire heat syndrome plays an important role in influencing blood flow velocity and blood vessel diameter.In unstable plaque,soft plaque is more likely to form under high phlegm heat score and high ESS level,and mixed plaque is more likely to form under low phlegm heat score and low ESS level.2.The diameter of the common carotid artery is negatively correlated with the single fire heat syndrome,and it is also negatively correlated with the blood flow velocity of the common carotid artery and blood lipids.In unstable plaques,the smaller the diameter of the common carotid artery,the more soft the plaques tend to be,and the larger the diameter,the more mixed the plaques tend to be.3.The Ty G index is positively correlated with the phlegm heat score,which is mainly influenced by the phlegm syndrome.To some extent,it is believed that an increase in the Ty G index can increase blood viscosity and improve ESS.In unstable plaques,high Ty G indices tend to be soft plaques,while low Ty G indices tend to be mixed plaques.4.All blood lipid indicators are positively correlated with ESS;There is a negative correlation between D-Di concentration and ESS level. |
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