超声检测胸主动脉粥样硬化的临床意义

Assessment of clinical value of thoracic atherosclerosis by transesophageal echocardiography

目的：探讨胸主动脉粥样硬化的临床意义。方法：应用经食管超声心动图检测４１例正常人、４２例高血压、４９例冠心病和３１例脑梗死患者的胸主动脉粥样斑块的形成，测量胸主动脉内径及内膜中层厚度（ＩＭＴ）。结果：与对照组比较，其他３组胸主动脉内径扩大，ＩＭＴ增厚；胸主动脉粥样斑块的检出率由高到低依次为脑梗死组＞冠心病组＞高血压病组；胸主动脉粥样斑块诊断冠心病的敏感性为６３．２７％，特异性为９７．５６％。结论：胸主动脉内径扩大、ＩＭＴ增厚是高血压、动脉粥样硬化的一种血管重构现象；胸主动脉粥样斑块是预测冠心病的有用指标。

Objective:To assess the clinical value of thora cic atherosclerosis.Methods:Tansesophageal echocardiography was performed in 41 normal subjects,42 hypertensive patients,49 patients wi th coronary heart disease (CHD) and 31 patients with stroke. Diameter and intimal medial thickness (IMT) of the aorta were measured and intra aortic plaques were detected. Results:The aortic diameter and IMT in patients with hypertension, CHD or stroke had increased compared with those in the control group. The detection rate of aortic plaques was 50% in hypertension, 6 3.27% in CHD and 93.55% in stroke, respectively. The sensitivity and specificity of aortic plaque for diagnosing CHD were respectively 63.27% and 97.56%. Conclusions:Increased aortic diameter and IMT are phenomena of vascular remodeling in patients with hypertension and atherosclerosis.The formati on of intra aortic plaque is a practical index for the detection of CHD.