Study On The Application Of Intravascular Ultrasound In Coronary Artery Critical Lesions In Patients With Phlegm And Blood Stasis Syndrome Of Coronary Heart Disease

Objective:Based on the technique of intracoronary intravascular ultrasound,the purpose of this study is to explore the inherent pathological characteristics and relationship between phlegm and blood stasis and coronary artery critical lesion plaque in CHD,so as to provide objective theoretical support for TCM syndrome differentiation and treatment to identify high-risk population of CHD.Methods:From October 2017 to December 2018,124 patients with coronary heart disease diagnosed by coronary angiography and examined by intravascular ultrasound were hospitalized in the cardiovascular ward of our hospital.The selected patients were divided into syndrome differentiation groups by senior professional physicians,and finally 98 patients were included after inclusion exclusion criteria and elimination and shedding criteria.Among them,phlegm syndrome 32,blood stasis syndrome 25,phlegm and blood stasis syndrome 41.Then the extravascular elastic membrane area,plaque area,remodeling index,plaque eccentricity index,plaque maximum thickness,plaque minimum thickness,plaque lipid ratio,blood lipid level,C-reactive protein,cardiac ejection fraction,recurrent angina pectoris and percutaneous coronary intervention were analyzed in the three groups.the difference between coronary radiography and intracoronary ultrasound stenosis rate.All the data were processed and analyzed by SPSS22.0 software,and the difference was statistically significant when P<0.05;Drawing with Graphpad.Results:1.There was no significant difference in basic clinical data,biochemical indexes and cardiac ejection fraction among phlegm-turbid syndrome group,blood stasis syndrome group and phlegm-blood stasis syndrome group(P>0.05);2.In the comparative analysis of intravascular ultrasound measurements,the extravascular elastic membrane area,plaque area,plaque load and remodeling index in phlegm-stasis syndrome group were larger than those in phlegm-turbid syndrome group and blood stasis syndrome group(P<0.05);There was no significant difference in extravascular elastic membrane area,plaque load and remodeling index between phlegm-turbid syndrome group and blood stasis syndrome group(P>0.05);In the comparison of IVUS showing stenosis rate,minimum lumen area,lipid pool area,plaque lipid ratio,plaque maximum thickness,plaque minimum thickness,average lumen diameter and plaque eccentricity index,there was no significant difference among the three groups of phlegm-turbid syndrome,blood stasis syndrome and phlegm-blood stasis syndrome.(P>0.05);3.The number of angina pectoris in the phlegm-stasis syndrome group was more than that in the phlegm-turbid syndrome group and the blood stasis syndrome group(P<0.05),but there was no significant difference in the number of angina pectoris between the phlegm-turbid syndrome group and the blood stasis syndrome group(P>0.05);4.The number of patients with acute coronary events in phlegm-stasis syndrome group was more than that in phlegm-turbid syndrome group and blood stasis syndrome group(P<0.05),but there was no significant difference5.between phlegm-turbid syndrome group and blood stasis syndrome group(P>0.05);6.The rate of coronary artery stenosis shown by IVUS in patients with phlegm and blood stasis syndrome was higher than that in CAG(P<0.05),but there was no significant difference between phlegm-turbid syndrome group and blood stasis syndrome group(P>0.05).Conclusion:In patients with coronary artery borderline disease of coronary heart disease,intravascular ultrasound examination shows that patients with phlegm and blood stasis syndrome have high instability of coronary plaque and high risk of cardiovascular events,so more attention should be paid to prevention and treatment in clinic.