冠心病患者颈动脉粥样硬化与冠状动脉造影的关系

Relationship between carotid atherosclerosis and coronary angiography in patients with coronary heart disease

目的评价颈动脉粥样硬化与冠状动脉性心脏病(冠心病)的关系。方法对冠状动脉造影证实的冠心病患者153例(冠心病组)和非冠心病者(正常组)42例进行双侧颈动脉超声检查,测定血管后壁内膜-中膜厚度(inteima-media thickness,IMT),记录斑块数目,并计算斑块积分,同时冠心病组按血管狭窄累及主要病变血管支数分为单支病变亚组(63例)、双支病变亚组(49例)、3支病变亚组(41例)。结果冠心病组斑块发生率[68%(104/153) vs.11.9%(5/42),P<0.05]、颈动脉IMT[(1.11±0.19)mm vs.(0.82±0.06)mm,P<0.05]、斑块积分[(5.03±3.33)分vs.(1.11±0.75)分,P<0.05]和Gensini评分[(21.7±10.3)分vs.(0.0±0.0)分,P<0.05]比正常组高,差异有统计学意义。冠心病3支病变亚组和双支病变亚组斑块发生率、颈动脉IMT、斑块积分和Gensini评分均比单支病变亚组高,差异有统计学意义(P<0.05)。冠心病、原发性高血压、糖尿病、低密度脂蛋白、吸烟、肥胖与颈动脉IMT呈显著正相关(P<0.05)。结论颈动脉粥样硬化超声检查可间接预示冠心病及其严重程度。

Objectives To observe the relationship between carotid atherosclerosis and coronary artery atherosclerosis. Methods Intima-media thickness(IMT) was measured in 154 patients with coronary artery disease(CAD) and in 42 patients without CAD diagnosed by coronary arteriography(CAG).The numbers of plaque were recorded and the grades were quantified.Patients with CAG were further divided into 1-branch group(n=63),2-branch group(n=49), and 3-branch group(n=41) according to the number of major coronary vessels with...