基于DSA血管影像特征的非创伤性股骨头坏死中医证型血瘀程度变化规律分析OA

To analyze the changing pattern of blood stasis degree in different TCM syndromes of non-traumatic osteonecrosis of femoral head(NONFH),the present study adopted a retrospective cross-sectional design.The clinical and digital subtraction angiography(DSA)data were collected from 60 NONFH patients with blood stasis syndrome treated at the Third Affiliated Hospital of Beijing University of Chinese Medicine from February 2022 to March 2025.According to Chinese Medicine Identification Criteria for Necrosis of the Femoral Head(2019 edition),60 patients were allocated into three groups of phlegm-stasis obstruction of collaterals,meridian obstruction,and liver-kidney deficiency,with 20 patients in each group.The morphological features of blood vessels were observed by DSA,and the diameter of the profunda femoris artery,diameters of medial/lateral circumflex femoral arteries,and vessel count were recorded.The degrees of blood stasis in different syndrome groups were analyzed.The results showed that there were 38 males and 22 females among the 60 patients,with mean age of(41.18±14.56)years.Two,thirty-three,twenty-two,and one patients were in ARCO stages Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.There was no difference in the baseline data(age,BMI,etc.)among the three groups.Regarding the vascular parameters,the meridian obstruction group had the profunda femoris artery diameter of(6.59±0.94)mm,medial circumflex femoral artery diameter of(2.99±0.42)mm,medial/lateral ratio of 0.50(0.43,0.58),and total number of arteries being 8.00(7.00,8.00),which were all lower than those in the phlegm-stasis obstruction group and the liver-kidney deficiency group(P<0.05,P<0.01).The results indicated that the DSA of NONFH patients with blood stasis presented abnormal vascular morphology,and their vascular images showed a certain pattern throughout the disease course,with lower vessel diameter and count in the middle stage.This result suggested that the degree of blood stasis in the patients varied from mild to severe and back again with the progression of the disease.This study not only provides quantifiable imaging indicators for the macroscopic diagnosis of blood stasis syndrome and verify its dynamic evolution law,but also suggests that in clinical practice,imaging techniques such as DSA can be used to assist in syndrome differentiation and classification.This provides objective references for staged treatment and the optimization of intervention timing and intensity of blood-activating and stasis-resolving regimens.