超声检测颈动脉对冠心病的预诊断价值

Relationship Between Carotid Atherosclerosis and Coronary Heart Desease

目的探讨颈动脉粥样硬化与冠心病的关系。方法对91例冠心病的患者行冠状动脉造影和颈动脉超声检查。分为对照(CON)组、稳定型心绞痛(SAP)组和不稳定型心绞痛(UAP)组。结果SAP组和UAP组的IMT值、颈动脉硬化和斑块形成的阳性率均明显高于CON组(P<0.01);冠脉单支和多支病变组与CON组比较上述指标亦有明显增高(P<0.01);UAP组不稳定型斑块比例显著高于SAP组(P<0.01)。比较两者的检出率,颈动脉硬化具有较高的敏感度,特异性偏低;而粥样斑块形成则有较高的特异性,敏感度较低,阳性似然比、阴性似然比均高于颈动脉硬化。结论测定颈动脉壁厚度、粥样斑块及其性质,对冠心病的预测具有临床意义。

Objective To investigate the relationship between carotid atherosclercsis and coronary atherosclerosis cardiopathy. Methods 91 suspect patients with coronary artery disease （CAD） were divided into control （ CON ） group, stable angina pectoris （SAP） group and unstable angina pectoris（ USP）group. Coronary arteriography, carotid arteriography and carotid ultrasonic examination were performed in all patients. Results IMT and the positive rate of carotid atherosclerosis in SAP group and USP group is higher than that in control group （ P〈 0.01 ）. And that in patients with single - branch - lesion and poly - branch - lesion was higher than that in control group （ P 〈 0.01 ）. The proportion of unstable carotid plaque to all patients in UAP group was higher than that in SAP group （ P〈 0. 01 ）. Compared with carotid atherosclerosis, carotid atheromatous plaque has higher specificity,positive likelihood ratio and negative likelihood ratio, but a lower sensitivity. Conclusions Detecting carotid atherosclerosis by ultrasonography has some clinical significance for predicting CAD.