颈动脉超声与冠状动脉造影对颈动脉粥样硬化的评估作用

Evaluation of carotid ultrasonography and coronary arteriongraphy on integral grade of carotid atherosclerosis

目的:研究冠心病与颈动脉粥样硬化的相关性及颈动脉超声对动脉粥样硬化的评估作用。方法:对62例疑似冠心病的患者,行颈动脉超声,观察动脉壁厚度,有无斑块及斑块形态、大小,有无狭窄及阻塞和冠状动脉造影检查,观察前降支、左回旋支和右冠状动脉。结果:心绞痛组的颈动脉粥样硬化等级积分,Crouse积分和斑块数(个)分别为6.78±4.27,5.21±3.94,2.21±1.64,心肌梗死组的颈动脉粥样硬化等级积分,Crouse积分和斑块数分别为8.16±4.11,5.72±4.03,2.83±1.84,均明显高于非冠心病组,差异有显著性意义(t=2.95,1.85,2.52,P<0.01～0.001),冠状动脉单支和多支病变组与非冠心病组的颈动脉粥样硬化指标差异亦有显著性意义(t=2.65～3.16;P<0.001～0.0001);在冠状动脉造影呈阴性的50例中,41例颈动脉超声有动脉硬化斑块,9例无动脉硬化斑块,敏感性为82%,特异性为75%,总的诊断符合率为81%。结论:测定颈动脉粥样硬化斑块的总积分对冠心病的疗效评价具有重要的参考价值。

AIM:To study the correlation of coronary heart disease with carotid atheroscle rosis. METHODS:Carotid ultrasonography and coronary arteriongraphy were conducted to 62 cases doubted with coronary heart disease, and their thickness of walls of ca rotid artery,existence, shape and size of plaque, existence of stenosis and occl usion, anterior descending branch, left rotary branch of coronary artery and rig ht coronary artery were observed. RESULTS:The integral grade, Crouse grade and number of plaque in the angina gr oup(6.78±4.27,5.21±3.94,2.21±1.64) and myocardial infarction group(8.16±4.11 ,5.72±4.03,2.83±1.84) were significantly higher than those in the non-coronar y heart disease group(t=2.95,1.85,2.52;P< 0.01-0.001).The index of carotid athe rosclerosis in single branch and multi-branch lesion groups were significantly different from that in the non-coronary heart disease group(t=2.65-3.16;P< 0.0 01-0.000 1). Among the 50 cases with negative coronary arteriongraphy, plaques were observed in 41 cases, and not observed in 9 cases,the sensibility was 82%, specificity was 75%,and the total accordant rate of diagnosis was 81%. CONCLUSION:It is an important reference for the evaluation on the efficacy of coronary heart disease to measure the total score of plaque of carotid atheroscl erosis.