肝豆状核变性不同心肌纤维化程度患者的舌象客观化特征研究OA

Objective To provide a reference basis for traditional Chinese medicine tongue diagnosis in the assessment of hepatolenticular degeneration myocardial fibrosis,this study aimed to investigate the objective characteristics of tongue manifestations in patients with hepatolenticular degeneration who exhibit varying degrees of myocardial fibrosis.Methods This study adopted a cross-sectional research design.A total of 65 patients with hepatolenticular degeneration who were treated at the Department of Neurology,The First Affiliated Hospital of Anhui University of Chinese Medicine,from September 2024 to September 2025,were enrolled.ECV values were obtained using T1 mapping of cardiac magnetic resonance imaging,and patients were divided into a mild myocardial fibrosis(ECV<28.9%,n=39)and moderate to severe myocardial fibrosis groups(ECV≥28.9%,n=26).The patients' general characteristics were recorded,including age,sex,illness duration,systolic and diastolic blood pressure,pulse rate,and clinical classification.Height and body weight were recorded,and body surface area was calculated.Tongue images were captured using the YZAI-02 Traditional Chinese Medicine AI Tongue Imaging System,and objective parameters relating to tongue color,tongue texture,coating color,coating texture,and sublingual vessels were extracted to compare the differences between the two groups.Results The moderate to severe myocardial fibrosis group had a longer duration of illness and a higher proportion of neurological hepatolenticular degeneration than the mild myocardial fibrosis group(P<0.05).A significant difference was observed in the distribution of tongue color between the two groups.The proportion of pale red tongues was lower,and the proportion of pale dull tongues was higher in the moderate to severe myocardial fibrosis group than in the mild myocardial fibrosis group(P<0.05).The saturation(S)and brightness(V)of the tongue apex color,as well as the S value of the tongue color in the tongue center,were all lower in the moderate to severe myocardial fibrosis group than in the mild myocardial fibrosis group(P<0.05).A significant difference was observed in the distribution of tongue coating colors between the two groups.The moderate to severe myocardial fibrosis group had a higher proportion of white coating and a lower proportion of pale-yellow coating than the mild myocardial fibrosis group(P<0.05).The moderate to severe myocardial fibrosis group had lower values for both the hue(H)and S values of the tongue root coating than the mild myocardial fibrosis group(P<0.05).A significant difference was observed in the distribution of tongue coating thickness between the two patient groups.The proportion of patients with mild coating was lower than in the mild myocardial fibrosis group,whereas the proportion with moderate coating was higher in the moderate to severe myocardial fibrosis group.Compared with patients in the mild myocardial fibrosis group,the left and right main trunks in the moderate to severe myocardial fibrosis group exhibited increased length to width ratios;the left main trunk showed reduced red,green(G),and blue values,as well as reduced H,S,and V values,while the right main trunk exhibited reduced G and V values(P<0.05).Conclusion The primary tongue manifestation characteristics are pale-red tongue,pale-yellow coating,and mildly greasy coating in patients with mild hepatolenticular degeneration-associated myocardial fibrosis.In contrast,in patients with moderate to severe myocardial fibrosis,the primary characteristics are pale-dark tongue,white coating,and moderately greasy coating,often accompanied by widened and elongated sublingual capillaries with a dull color.