高频体表超声检测急性冠状动脉综合征患者颈动脉结构及功能

The Study of Characteristics of Carotid Artery with High-frequency Ultrasound in Diagnosis of Acute Coronary Syndrome

应用高频体表超声观察急性冠状动脉综合征患者颈动脉结构及血管内皮功能的变化 ,探讨动脉粥样硬化结构和功能与急性冠状动脉综合征的关系。对 35例急性冠状动脉综合征患者检测了颈动脉粥样硬化斑块、内膜中膜厚度、肱动脉内皮功能的变化 ,并与 2 7例稳定型心绞痛及 31例正常对照组进行比较。结果发现 ,内膜中膜厚度和内皮依赖性血管舒张功能在急性冠状动脉综合征组 (分别为 0 .10± 0 .0 2和 3.98± 1.6 5 )和稳定型心绞痛组(分别为 0 .11± 0 .0 4和 4 .76± 2 .37)与对照组 (分别为 0 .0 7± 0 .0 1和 9.33± 3.4 7)有显著差异 (P <0 .0 5 ) ,斑块积分和斑块指数在急性冠状动脉综合征组 (分别为 4 .0 6± 2 .2 1和 3.14± 1.97)与稳定型心绞痛组 (分别为 4 .17± 1.76和3.2 1± 1.88)间无差异 (P >0 .0 5 ) ,急性冠状动脉综合征组颈动脉粥样硬化斑块以不稳定型为主。研究结果提示 ,外周血管超声检查可观察动脉粥样硬化病变 ,颈动脉结构及血管内皮功能与冠状动脉粥样硬化有关。

Aim To investigate the structure and function of carotid artery and endothelial function in patients of acute coronary syndrome with high-frequency ultrasound. To study the relation of atherosclerosis and acute coronary syndrome. Methods With high-frequency ultrasound, not only intimal-medial thickness (IMT), plaque of carotid arteries, but also endothelium-dependent relaxing function of brachial artery were measured in subjects with acute coronary syndrome, stable angina pectoris and controls. Results IMT and endothelium-dependent relaxing function in acute coronary syndrome group (0.10±0.02 and 3.98±1.65) and stable angina pectoris group (0.11±0.04 and 4.76±2.37) were significantly higher than those in controls (0.07±0.01 and 9.33±3.47)(P<0.05). Plaque scores, plaque index in acute coronary syndrome group (4.06±2.21 and 3.14±1.97) were not significantly higher than those in stable angina pectoris group (4.17±1.76 and 3.21±1.88) (P>0.05). Unstable plaques were more common than stable plaques in acute coronary syndrome. Conclusion Peripheral blood vessel sonophic examination can measure athersclerosis. The structure and function of carotid artery and endolial function were associated with coronary atherosclerosis.