血管回声跟踪技术评价冠心病患者颈动脉早期硬化的价值

Value of vascular echo tracking technique in the assessment early atherosclerosis of carotid artery in patients with coronary heart disease

目的:探讨血管回声跟踪(ET)技术评价冠心病患者颈动脉早期硬化的价值及其与冠心病分级的关系,以期能为早期发现及诊断冠心病提供参考。方法:选取100例冠状动脉造影确诊为冠心病的患者为冠心病组,50例门诊正常体检者为对照组,应用ET技术测定颈动脉相关参数:颈动脉血管收缩期内径(Ds)、舒张期内径(Dd)、硬化参数(β)、顺应性(AC)、压力-应变弹性系数(Ep)、增大指数(AI)、单点脉搏波传导速度(PWVβ)、内中膜厚度(IMT)。结果:冠心病组与对照组Ds、Dd比较,差异无统计学意义(P>0.05),冠心病组β、Ep、AI、PWVβ、IMT高于对照组,AC低于对照组,差异均具有统计学意义(P<0.05);冠状动脉造影结果显示单支病变者47例,二支病变者39例,三支病变者14例,不同分支病变阳性的患者Ds、Dd比较,差异无统计学意义(P>0.05),β、Ep、AI、PWVβ、AC、IMT各组间有所不同,β、Ep、AI、PWVβ、IMT随着累及冠状动脉分支的增多有所升高,AC随着累及冠状动脉分支的增多有所下降,各组间比较差异具有统计学意义(P<0.05)。结论:冠心病患者颈动脉弹性明显降低,存在硬化变化,冠状动脉累及分支越多颈动脉硬化程度约严重,ET技术监测冠心病患者颈动脉早期硬化可行,有助于评估患者病情严重程度,为早期判断患者冠状动脉硬化的趋势提供了参考。

Objective. To investigate value of vascular echo tracking technique （ET） in detecting early atherosclerosis of carotid artery in patients with coronary heart disease （CHD） and to provide refer- ences for early detection and diagnosis of coronary heart disease （CHD）. Methods. Select 100 CHD pa- tients confirmed by coronary angiography as CHD group, 50 healthy volunteers as control group. Premas- ters including carotid artery systolic diameter （Ds）, and diastolic diameter （Dd）, hardening parameter（13）, compliance （AC）, stress and strain modulus of elasticity （Ep）, increase index （AI）, single point pulse wave conduction velocity （PWVI3）, intima-media thickness （IMT） were detected by ET technique. Results. There was no significant difference in Ds, Dd between the two groups （P〈0. 05）. CHD group showed higher ,Ep,AI,PWV1,IMT values than the control group （P〈0. 05）, but lower AC than the control group （P〈0. 05）. Coronary angiography results showed single lesions in 47 cases, bronchitis pathological changes in 39 cases, triple lesions in 14 cases. No significant difference in Ds and Dd was found among patients with different number of lesions （P〉0.05）, but ,Ep,AI,PWV1,IMT values in- creased with the number of lesions, AC value decreased with the number of lesions all showing significant difference （P〈0.05）. Oonolusion：Carotid artery elasticity decreased obviously in patients with coronary heart disease, and the severity of carotid artery sclerosis increased with number of involved branches. It＇s feasible to detect early carotid sclerosis using ET technology, and it＇s useful for evaluation severity of the disease and provide reference for its prognosis.