冠心病合并颈动脉狭窄患者血管病变相关因素分析

Analysis of related factors of vascular lesions in coronary heart disease patients with carotid artery stenosis

目的分析冠心病合并颈动脉狭窄患者血管病变相关因素。方法收集北京安贞医院2010年1—12月行冠状动脉造影并确诊为冠心病住院患者329例，依据颈动脉超声结果分为颈动脉狭窄＜50％组（272例）和颈动脉狭窄≥50％组（57例），统计分析2组患者血管病变及相关因素。结果①冠心病患者中颈动脉狭窄≥50％的患病率为17．3％（57／329），颈动脉狭窄≥70％的患病率为3．6％（12／329）。②合并颈动脉狭窄≥50％的冠心病患者中冠状动脉多支病变比例为66．7％（38／57），明显高于颈动脉狭窄＜50％组[52．2％（142／272）]（P＜0．05）。③2组问年龄、BMI、脉压差、血脂水平、空腹血糖、糖化血红蛋白（HbA1c）、血尿酸水平比较，差异无统计学意义（P＞0．05）。④多支病变与冠心病合并颈动脉狭窄≥50％（r=0．01，P=0．046）、2型糖尿病（r=0．11，P=0．046）有相关性。结论冠状动脉多支病变与颈动脉狭窄≥50％有相关性。

Objective To analyze the related factors of vascular lesions in coronary heart disease patients with carotid artery stenosis. Methods Totally 329 hospitalized patients with coronary artery disease confirmed by coronary angiography were retrospectively analyzed from January to December in 2010. All the participants under- went carotid uhrasonography. According to the carotid ultrasonography results, all the participants were divided into two groups inoluding carotid stenosis 〈 50% （ 272 cases ） and carotid stenosis ≥ 50% （ 57 cases ）. Vascular lesions and related factors of two groups were statistically analyzed. Results ①The morbidity was 17.3% （57/329） in ca- rotid stenosis≥50% group and 3.6% （12/329） in carotid stenosis ≥70%. ②The ratio of coronary multivessel le- sion was 66.7% （38/57） in carotid stenosis ≥50% group, which was higher than that in the control group [ 52.2% （142/272） ] （ P 〈0.05 ）. ③There was no significant difference between the two groups in age, body mass index （BMI）, pulse pressure, blood lipid levels, fasting blood glucose （FBG）, glyeosylated hemoglobin （HbAlc） and blood uric acid（UA） levels （ P 〉 0.05 ）. ④ Coronary muhivessel lesion was associated with carotid stenosis≥50% （ r = 0. 11, P = 0. 046 ） and type 2 diabets （ r = 0.11, P = 0. 046 ）. Conclusion The ratio of coronary multivessel le- sion in coronary heart disease patients with carotid artery stenosis ≥50% is obviously higher than that in patients with carotid artery stenosis 〈 50% ; coronary multivessel lesion is a risk factor of carotid stenosis ≥50%.