超声诊断对颈动脉硬化斑块及冠心病发生发展的预测价值

The predictive value of ultrasound analysis for the evaluation of carotid plaque for the incidence and development of coronary heart disease

目的应用超声观察临床疑诊冠心病患者的颈动脉斑块稳定性及斑块的病理性质，探讨其对冠心病发生发展的预测价值。方法对92例疑诊冠心病的住院患者行冠状动脉造影及颈动脉超声检查，根据颈动脉斑块的稳定性不同分为斑块稳定组（41例）及斑块不稳定组（51例），比较2组患者冠心病发病率，评估颈动脉稳定性检查对冠心病的预测价值；根据斑块的病理性质分为硬斑组（12例）、软斑组（27例）、混合斑组（53例），比较三组患者冠状动脉病变的严重程度，评估颈动脉斑块病理性质检查对冠心病进展的预测价值。结果斑块不稳定组较斑块稳定组冠心病比较明显较多[74．5％（38／51）比31．7％（13／41）]，混合斑组冠状动脉重度狭窄的患者比例较硬斑组明显较多[73．6％（39／53）比16．7％（2／12）]，软斑组非冠心病的患者比例较混合斑组明显较多[81．5％（22／27）比9．4％（5／53）]，差异有统计学意义（P〈0．05）。结论应用超声检查颈动脉斑块的稳定性并判断斑块的病理性质对提示心血管疾病患者冠心病的发生发展有着良好的预测价值。

Objective To evaluate the carotid artery plaque stability and plaque pathological nature with ul- trasound and to explore their predictive value of ultrasound for the incidence and development of coronary heart disease. Methods 92 hospitalized patients were divided into carotid stable （41 cases） and instable （51 cases） groups after the results of coronary angiography. According to the pathological nature of the plaque, they were also divided into hard （12 cases）, soft （27 cases）, mixed （53 cases） plaque groups, and the three groups were com- pared in the severity of coronary artery disease to assess the predictive value of check pathological nature of carotid plaque on the progress of coronary heart disease. Results The incidence of coronary heart disease in instable plaque group were significantly higher than plaque stable group; The occurency of severe stenosis of coronary in the patients with the mixed plaque group were significantly higher than the hard plaques group [ 73.6% （39/53） vs 16. 7% （2/12） ] ; rate of soft plaque group with non-coronary heart disease were significantly higher than mixed plaque group [ 81.5 % （22/27） vs 9.4% （5/53） ], which was statistically significant （P 〈 0.05 ）. Conclusion Ultrasound has a good predictive value to evaluate the incidence and development of coronary heart disease by determining the stability and pathological nature of carotid plaque.