颈总动脉内-中膜厚度及内-中膜横切面面积对冠心病的预测价值

Value of Carotid Artery Intima-media Thickness and Cross-sectional Area in Prediction of Coronary Heart Disease

目的探讨颈总动脉内-中膜厚度(IMT)、内-中膜横切面面积(IMCSA)对冠心病的预测价值。方法根据冠状动脉造影结果将81例行冠状动脉检查者分为冠心病组(51例)和对照组(30例),再根据受累冠状动脉数量将冠心病组分为一支病变组(10例)、二支病变组(22例)及三支病变组(19例)。超声测定所有病例双侧颈总动脉IMT、IMCSA,并进行分析。结果冠心病组左侧颈总动脉IMT为(0.92±0.15)mm,IMCSA为(22.0±2.8)mm2,而对照组左侧颈总动脉IMT为(0.85±0.07)mm,IMCSA为(18.4±2.1)mm2,两组左侧颈总动脉IMT及IMCSA比较,差异均有统计学意义(P<0.05);而两组右侧颈总动脉IMT、IMCSA比较,差异无统计学意义(P>0.05)。随着冠状动脉病变支数的增加,双侧颈总动脉斑块发生率亦增加(P<0.01)。以左侧颈总动脉IMT≥0.90 mm预测冠心病的敏感度为64.7%,特异度为66.7%;以左侧颈总动脉IMCSA≥20 mm2预测冠心病的敏感度为80.4%,特异度为86.7%。结论颈总动脉斑块的检出,同时结合左侧颈总动脉IMT及IMCSA,尤其是IMCSA,可以作为预测冠心病的指标及是否进行冠状动脉造影的筛选方法。

Objective To explore the relationship of carotid Intima-media thickness and cross-sectional area to coronary diseases（CD）.Methods Eighty-one subjects receiving CD examination were divided,according to the results of coronary angiography,into groups CD（n=51） and control（n=30）,and group CD subdivided,based on the number of involved coronary arteries,into groups 1-（n=10）,2-（n=22）,3-artery（n=19）.Bilateral common carotid artery IMT,IMCSA were measured by ultrasound and analyzed in all cases.Results ITM,IMCSA of left common carotid artery were 0.92±0.15 mm,22.0±2.8 mm^2,respectively,in CD group and 0.85±0.07 mm,18.4±2.1 mm^2,respectively,in control groups,the difference was significant（P〈0.05）.The incidence of bilateral common carotid artery plaque rose with the increase in number of injured coronary arteries（P〈0.01）.Taking left common carotid artery IMT≥0.90 mm as the border,the sensitivity and specificity of predicting CHD were 64.7%,66.7%,respectively,and taking IMCSA≥20 mm^2 as the border,were 80.4%,86.7%,respectively.Conclusion Detection of common carotid artery plaque,combined with left common carotid artery IMT and IMCSA（especially IMCSA）,can be used as indicators for prediction of CHD and a screening method deciding whether coronary angiography is needed.