颈动脉内-中膜厚度和肱动脉血流介导的舒张功能与冠心病的关系

The carotid intima-media thickness and the flow mediated vasodilatation of brachial were related with coronary heart disease

目的探讨颈动脉粥样硬化斑块发生率、颈动脉内-中膜厚度(IMTc)及肱动脉血流介导的舒张功能(FMD)与冠心病的关系。方法应用高分辨率超声检测112例患者的颈动脉粥样硬化斑块、IMTc,同时检测肱动脉FMD,据造影结果将患者分为冠心病组79例与对照组33例,对冠状动脉病变程度进行Gensi-ni评分。结果冠心病组与对照组比较,颈动脉粥样硬化斑块发生率、FMD及IMTc差异具有统计学意义(P<0.05)。直线相关分析表明,FMD与冠状动脉病变Gensini积分呈负相关,(r=-0.362,P<0.01),IMTc与冠状动脉病变Gensini积分呈正相关(r=0.296,P<0.01)。结论联合应用无创高分辨率超声检测颈动脉粥样硬化斑块、IMTc及FMD可间接反映冠心病发生的可能性以及预测冠状动脉病变程度,而且方法简单、无创,为早期诊断冠心病提供了一种安全可靠的手段。

Objective To investigate the relationship between the coronary heart disease （CHD） and carotid atherosclerosis and the Carotid intima-media thickness （IMTc）and the flow mediated vasodilatation（FMD） of brachial. Methods The carotid atherosclerosis plaque and the IMTc and the FMD of brachial were examined in 112 patients by high resolution ultrasound. All of these patients were divided into coronary heart disease group （79 cases） and control group（33 cases） according to results of coronary angiography. The extent of coronary lesions was evaluated with Gensini score. Results The rate of carotid atherosclerosis, FMD and IMTc were deference between coronary heart disease group and control group （P〈0.05）. Linear correlation analysis showed that FMD were negative to Gensini score （r=-0.362,P〈0.01）, and IMTc were positive to Gensini score （r=0.296,P〈0.01）. Conclusion It may be helpful that using non-invasive high resolution ultrasound examine the carotid atherosclerosis plaque and the IMTc and the FMD to reveal the possibility and extension of coronary heart disease indirectly. This is a simple, non-invasive and effective method in earlier diagnosis coronary heart disease.