冠心病治疗前后颈动脉硬化斑块及内中膜厚度的变化

Changes of carotid arteriosclerotic plaque and intima-media thickness in patients with coronary heart disease before and after therapy

目的探讨冠心病患者治疗前后,颈动脉硬化斑块及颈动脉内中膜厚度(IMT)的变化,了解冠心病与颈动脉硬化斑块间的相关性,为防治冠心病提供有关诊疗依据。方法选择经冠状动脉造影检查诊断患有冠心病,同时经颈动脉超声检查明确伴有颈动脉硬化斑块及IMT异常的冠心病患者240例为对象,按冠心病常规药物治疗,定期做颈动脉B超检查,对比治疗前后颈动脉硬化斑块及IMT的变化情况。结果治疗6、12个月,总胆固醇和低密度脂蛋白均较治疗前显著降低(P<0.05或P<0.01),颈动脉IMT、颈动脉斑块数和斑块的总面积改善情况与治疗前比较,均有非常显著性差异(P<0.01)。结论冠心病经治疗后,颈动脉硬化斑块及颈动脉IMT随之明显改善,冠状动脉硬化与颈动脉硬化的发病和治疗转归关系密切。

Objective To investigate the changes of carotid arteriosclerotic plaque and carotid intima-media thickness（IMT）before and after therapy in patients with coronary heart disease（CHD）,and to study the correlation between carotid arteriosclerotic plaque and CHD in order to provide references for its diagnosis and treatment.Methods 240 patients with CHD diagnosed by coronary arteriography and with carotid arteriosclerotic plaque and abnormal carotid IMT confirmed by Doppler ultrasonography were selected.All of them were treated with routine anti-CHD drugs and examined regularly by carotid ultrasonography.Eventually,the changes of carotid arteriosclerotic plaque and carotid IMT were compared between before and after therapy.Results After therapy for 6 months or 12 months,the levels of total Cholesterol and low-density lipoprotein were significantly lowered than those before therapy（P〈0.05 or P〈0.01）.Moreover,carotid IMT,the size and number of carotid arteriosclerotic plaque were very significantly improved after therapy than those before therapy（P〈0.01）.Conclusion Carotid arteriosclerotic plaque and carotid IMT in patients with CHD may be obviously improved after anti-CHD therapy.Coronary arteriosclerosis is closely associated with the onset and prognosis of carotid atherosclerosis.