颈动脉内-中膜厚度与冠状动脉粥样硬化性心脏病相关性研究

The dependability between carotid artery intima-media thickness and coronary atherosclerotic heart disease

目的:探讨颈动脉内-中膜厚度在预测冠心病及其程度中的价值。方法:收集361例研究对象的体重、身高、血压、血脂等数据。行颈部血管超声分别测量左右颈总动脉、颈内动脉、颈外动脉和颈动脉分叉的内-中膜厚度。采用标准的Judkins技术行冠状动脉造影。根据造影结果分为正常组、单支病变组、双支病变组、3支病变组共4组。进行颈动脉内-中膜厚度与冠心病的相关性研究。结果:冠心病不同严重程度组中颈动脉不同位点内-中膜厚度值与正常组比较均差异有统计学意义,其冠心病不同严重程度组间颈动脉不同位点内-中膜厚度值比较也均存在统计学差异。颈动脉内-中膜厚度值随冠状动脉病变程度的加重而增厚。左、右颈动脉分叉的特异度、阳性预测值、阴性预测值、准确度、约登指数及阳性似然比最高。年龄、TC、TG、LDL是颈动脉内-中膜的危险因素,而HDL是其保护因素。结论:颈动脉内-中膜厚度与冠心病严重程度明显相关。颈动脉内-中膜厚度可以作为筛选冠心病的指标。

Objective：To study the value of intima-media thickness（IMT） of carotid artery in predicting coronary atherosclerotic heart disease（CHD） and the level of it. Method：361 patients were be selected in random. We collected these indexes as follow： Measured body weight, body height, blood pressure and blood fat. Detected the IMT of common carotid artery（CCA）,internal carotid artery（ICA）, external carotid artery（ECA） and carotid artery bifurcate（CAB） use the high resolution B-mode ultrasonography, vsed the standard Judkins skill to make coronary arteriongraphy（CAG）. According to the result of CAG, we divided the patients into normal group, 1 vessel abnormal group, 2 vessel abnormal group, 3 vessel abnormal group. To study The dependability between carotid artery intima-media thickness and coronary atherosclerotic heart disease. Result： There are statistics differences between the IMTs of different carotid artery site in different groups of CHD and normal group. And these are also exist in different groups of CHD. The result is that the more serious of CHD,the thicker in IMT of carotid artery. The specificity（Spe）, the positive predictive value（PV＋ ）, the negative predictive value（PV-） ,accuracy, Youden in- dex（YI） and positive likelihood ratio（LR＋ ） of left and right CAB are best. The result of logistic regression analysis is that age,cholesterol, triglyceride,LDL are risk factors of IMT of carotid artery,but HDL is safe factor of it. Conclusion： Between the IMT of carotid artery and the level of CHD exist obviously dependability. We can use the IMT of carotid artery as the index of screening CHD.