颈动脉粥样硬化与冠心病的关系

Relationship between carotid artery atherosclerosis and coronary artert disease

目的:探讨颈动脉粥样硬化与冠心病的关系。方法:根据冠状动脉造影结果将101例病人分为冠心病组及对照组,再根据受累血管数将冠心病组又分为一支病变组、二支病变组及三支病变组。应用高频超声测定所有病例双侧颈总动脉的内-中膜厚度(IMT)、颈总动脉内径,进行分析。结果:冠心病组的左颈动脉的平均IMT为(0.91±0.13)mm,平均内中膜横切面面积(IMCSA)为(22.13±3.21)mm2,而对照组的左颈动脉的平均IMT为(0.84±0.06)mm,平均IMCSA为(18.06±1.15)mm2,两组的差异有统计学意义(P<0.01);冠心病组斑块发生率为63.7%,对照组的斑块发生率为34.6%,差异有统计学意义(P<0.01)。以左颈总动脉IMT0.845mm为界限预测冠心病的敏感性为68.8%,特异性为67.3%;以左颈总动脉IMCSA19mm2为界限预测冠心病的敏感性为87.5%,特异性为84.6%。结论:颈动脉粥样硬化可作为冠心病的预测因子,为临床诊断提供依据。

Objective：To observe the relationship between intima-media thickness and carotid artery plaque in coronary heart disease. Methods： 101 patients who had been examined by coronary angiography were divided into normal group （52 patients） and coronary artery disease group（49 patients）. Carotid ultrasonography was performed in them. Results： In coronary disease group, the average IMT was （0. 91 ± 0. 13）ram , the average IMCSA was （22. 13 ± 3. 21）mm^2. In normal group, the average IMT was （0.84 ±0.06）mm , the average IMCSA was （18.06 ± 1. 15）mm^2, the difference was significative in statistics. In coronary disease group, carotid artery plague was found in 63.7% of the patients,but it was found in only 34.6% patients in normal group（P〈0.01）. To predict coronary disease, if IMT 0. 845mm was served as a separating criterion, the sensitivity was 68.8%, the speciality was 67.3% ; if IMCSA 19mm^2 was served as a separating criterion, the the sensitivity was 87. 5%, the speciality was 84. 6%. Conclusion： Carotid ultrasonography could be used to predict the present coronary heart disease.