颈动脉超声对冠状动脉狭窄患者缺血性脑血管疾病的评价及其与传统危险因素的关系

Evaluation of ischemic cerebrovascular lesions by ultrasonography in patients with coronary artery stenosis and its relationship with risk factors

目的探讨颈动脉超声对预测冠状动脉狭窄患者颅内动脉狭窄的价值,以及颈动脉超声相对于其它动脉粥样硬化主要危险因素预测缺血性心脑血管疾病的优越性。方法对209例经血管造影证实冠状动脉狭窄(≥70%)的患者采用彩色多谱勒血流成像(CDFI)和经颅多普勒超声(TCD)分别检查颈动脉和颅内动脉,并将患者分为颈动脉狭窄组与非狭窄组;脑动脉狭窄组与非狭窄组,分别比较狭窄组与非狭窄组之间的危险因素及生化指标,进一步对冠状动脉狭窄合并颅内动脉狭窄的主要危险因素与颈动脉超声结果中具有显著性统计学意义的指标,分析二者之间的相关性。结果颈动脉超声对缺血性心脑血管疾病的预测价值较传统的危险因素更高。结论高血压病、颈动脉球部内膜增厚、多发斑块及不均质回声斑块对冠状动脉狭窄患者颅内动脉狭窄有明显的促进作用。采用CDFI对确诊冠状动脉狭窄患者进行检测,对心脑血管事件高危人群进行筛选、评价治疗疗效和预后具有重要意义。

Objective To evaluate the value for predicting cerebrovascular stenosis in patients with coronary artery stcnosis via carotid ukrosonography and its advantages than traditional risk factors. Methods CDFI and TCD were used to examine the carotid artery and intracranial artery respectively for the 209 patients whose diagnosis of coronary artery stenosis（ ≥70% ） via selective coronary angiography. The patients were divided into carotid stenosis and non - carotid stenosis groups as well as intracranial artery stenosis and non - intracranial artery stenosis groups. The risk factor variables were evaluated in the stenosis and non - stenosis groups respectively. Results Carotid ultrasound findings were more sensitive for predicting the ischemic heart and cerebralvascular disease than traditional risk factors. Conclusion The carotid maximum intima - media thickness （ IMT）, hypertension, plaque number, heterogeneous plaque and multiple plaques seems to increase the risk for ischemic cerebralvaseular disease of coronary artery stenosis. Elucidate the relationship between the risk factors of intracranial and extra - cranial artery stenosis with coronary artery stenosis. Therefore, it is important for patient management and evaluation of therapies for stroke prevention . CDFI should be applied for ischemie coronary artery diseases patients.