联合检测颈动脉粥样斑块和hs-CRP对冠心病患者冠脉狭窄程度的评估价值

Value of testing of carotid artery plaque joint hs-CRP to the degree of coronary stenosis in patients with coronary heart disease

目的:探讨颈动脉内中膜厚度(intima-media thickness,IMT)、颈动脉粥样斑块Crouse积分联合超敏C-反应蛋白(high sensitivity C reactive protein,hs-CRP)血清浓度对冠心病患者冠脉狭窄程度的预测价值。方法:110例因胸闷、痛而疑是冠心病的入院患者1周内行冠状动脉造影、颈动脉超声检查,入院第2日进行hs-CRP血清浓度检测,依据冠状动脉造影(coronary angiography,CAG)结果分为冠心病组和正常对照组。评估三者联合检测的预测价值。结果:冠心病组血清hs-CRP浓度、颈动脉斑块IMT,Crouse积分均明显高于正常对照组(P<0.01),且各指标检测值的大小与冠脉狭窄程度均成正相关(r均>0.6,P<0.05)。如将Crouse积分≥10.7作为标准,则其灵敏度为78.5%,阳性预测值89.9%,Crouse积分<10.7的特异度79.0%,阴性预测值58.0%。结论:冠心病患者颈动脉粥样硬化斑块的IMT,Crouse积分联合血清hs-CRP浓度与冠状动脉造影所示冠脉狭窄程度具有较高的一致性,其可作为对冠心病患者血管狭窄程度的一项预测方法。

Objective： To study the predictive value of score of intima-media thickness（IMT）,Crouse in carotid artery plaque,and serum levels of high sensitivity C-reactive protein（hs-CRP） in the degree of coronary stenosis of patients with coronary artery disease.Methods： A total of 110 patients suspected coronary heart disease with chest pain were admitted to this study.They were divided into two groups： group of coronary heart disease and group of normal control according to the results of CAG.All patients underwent carotid ultrasonography within a week,and carried out the testing of serum concentrations of hs-CRP in second hospitalized day, to assess the determining and forecasting value of score of IMT and Crouse in carotid artery plaque, combining with serum levels of hs-CRP in the degree of coronary stenosis of patients with coronary artery disease. Results： Serum concentrations of hs-CRP,score of IMT, Crouse of group CHD were significantly higher than those of group non-CHD（P 〈0.01 ） , and each mentioned indicators in group CHD was positively correlated with the degree of coronary stenosis（r 〉 0.6, P 〈 0.05 ）. Taking Crouse points ≥ 10.7 as a standard,its sensitivity was 78.5%, positive predictive value was 89.9%, specificity was 79.0%, negative predictive value was 58.0%. Conclusion： There was a high consistency between serum concentrations of hs-CRP,score of IMT, Crouse and the degree of coronary stenosis, so we can use serum concentrations of hs-CRP,score of IMT, Crouse as a prediction method to coronary heart disease in patients with carotid artery atherosclerosis.