| ObjectiveCarotid atherosclerosis and lower extremity atherosclerotic affect the occurrence and prognosis of stroke events.In this study,a cross-sectional method was adopted,combined with the ultra superb micro-angiography(SMI)technology,through the analysis of the TCM and Western clinical data of atherosclerotic vascular stenosis in the carotid and lower extremities,to explore the TCM Sydrome sydrome and ultrasound imaging characteristics.MethodScreening a sample of 35 patients with carotid atherosclerosis with or without lower extremity atherosclerosis and meeting the inclusion criteria from October 2020 to March 2021 treated in our hospital,collecting basic data,four-diagnosis information,medical history related to risk factors and laboratory indicators such as blood lipids,homocysteine,uric acid,thrombosis risk detection,etc.,and determining TCM syndrome sydromes according to the"Atherosclerosis Expert Consensus on Integrated Traditional Chinese and Western Medicine".The patients were examined by vascular ultrasound+SMI technology to explore the carotid and lower extremity arterial intima-media thickness,plaque echo,plaque thickness,vascular stenosis,and neovascularization.All data were statistically analyzed after being collected.Result1.Characteristics of risk factors for atherosclerotic vascular stenosis in carotid and lower extremities:1.1 A total of 35 CAD patients were enrolled,of which 71.43%were combined with LEAD and 10 were 28.57%with CAD alone.1.2 The average age of patients with CAD and LEAD was 65.20±8.57 years,which was higher than the average age of patients with CAD alone,55.80±9.27 years(P<0.05).1.3 The prevalence of cerebrovascular disease in CAD patients with LEAD was 52%,which was higher than that in patients with CAD alone(P<0.05).1.4 There was no statistical difference between the two groups of patients in gender,hypertension,diabetes,hyperlipidemia,coronary heart disease,smoking history,drinking history,BMI,blood lipids,uric acid,homocysteine,and thrombosis risk indicators(P>0.05).2.Analysis of conventional ultrasound+ SMI results of atherosclerotic vascular stenosis in the neck and lower extremities:2.1 Under conventional ultrasound,the average carotid artery intima-media thickness of patients with CAD and LEAD was 0.11±0.02cm,which was greater than that of patients with CAD alone(P<0.05).The average thickness of carotid plaques in CAD patients with LEAD was 0.28±0.07cm,14 were hypoechoic,11 were mixed echo plaques,23 had mild stenosis,and 2 had severe stenosis or occlusion;the average thickness of carotid plaques in CAD patients was 0.24±0.05cm,5 hypoechoic plaques,5 mixed echo plaques,all of which were mildly narrow.There were no significant differences in the echo properties,average thickness,and degree of vascular stenosis of the plaques between the two groups(P>0.05).2.2 Using SMI technology,the detection rate of neovascularization in 35 carotid plaques was 51.43%,including 17 grade 0 plaques,14 grade 1 plaques,3 grade 2 plaques,and 1 grade 3 plaques.The detection rate of neovascularization in 25 lower extremity arterial plaques was 12%,including 22 grade 0 plaques,2 grade 1 plaques,and 1 grade 3 plaques.The detection rate of carotid plaque neovascularization in CAD patients with LEAD was 56%,and the detection rate of carotid plaque neovascularization in CAD patients was 40%.There was no statistical difference between the groups(P>0.05).3.Correlation analysis of TCM syndrome of atherosclerotic vascular stenosis in carotid and lower extremities:3.1 The overall distribution of TCM syndrome types of included patients:34.29%of phlegm and blood stasis and 31.43%of Qi and Yin deficiency are the most common,followed by patients with Qi deficiency and blood stasis,accounting for 25.71%,and patients with Qi stagnation and blood stasis,accounting for only 5.71%.3.2 In the CAD combined LEAD patient group,phlegm and blood stasis(44%)and Qi deficiency and blood stasis(32%)are the main ones,and the simple CAD patient group is mainly Qi and Yin deficiency(60%).The composition of TCM syndrome types between the two groups was statistically different(P<0.05)..3.3 The smoking rate of patients in the Qi and Yin deficiency group is low(P<0.05),there are no significant differences in gender,hypertension,diabetes,hyperlipidemia,coronary heart disease,cerebrovascular disease,drinking history,and BMI in various TCM syndrome types(P>0.05).3.4 The HCY level of patients in the Qi deficiency and blood stasis group was higher than that in the Qi and Yin deficiency group(P<0.05).The TG level of patients in the Qi and Yin deficiency group was higher than that of Qi deficiency and blood stasis,phlegm and blood stasis(P<0.05),and the TG level of Qi and blood stasis patients was higher than that of Qi deficiency and blood stasis(P<0.05).The test results of TC,LDL,HDL,uric acid and thrombosis risk index showed no significant difference among the TCM syndrome groups(P>0.05).3.5 The detection rate of neovascularization was low in patients with Qi deficiency and blood stasis group,and the detection rate of neovascularization was high in the phlegm and blood stasis group,and no neovascularization was detected in patients with Qi stagnation and blood stasis.There was a statistical difference between the groups(P<0.05).The detection rate of neovascularization in patients with CAD and LEAD from high to low was phlegm and blood stasis,Qi and Yin deficiency,qi deficiency and blood stasis,and Qi stagnation and blood stasis.There were statistical differences between the groups(P<0.05).There were no significant differences in carotid artery IMT,average plaque thickness,plaque echo type,degree of stenosis,and lower extremity arterial plaque echo type and degree of stenosis among different TCM syndrome groups(P>0.05).Conclusion1.The distribution of TCM syndrome types of CAD patients:phlegm and blood stasis interlocking>Qi and Yin deficiency>Qi deficiency and blood stasis>Qi stagnation and blood stasis.The patients with CAD combined with LEAD were mainly composed of phlegm and blood stasis,Qi deficiency and blood stasis,and patients with simple CAD were mainly characterized by Qi and Yin deficiency.2.In the phlegm and blood stasis group,the detection rate of neovascularization is high,and the plaque stability is poor. |
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