颈动脉超声在冠心病严重程度评估中的应用价值

Application value of carotid artery ultrasound in severity degree evaluation of coronary heart disease

目的探讨颈动脉超声在冠心病严重程度评估中的应用价值。方法应用颈动脉超声检查经冠脉造影检查除外冠心病患者(对照组,60例)、不稳定型心绞痛UA患者(UA组,74例)、急性心肌梗死(AMI)患者(AMI组,62例)的颈动脉内中膜厚度(IMT)并计算其Crouse积分,观察三组患者间IMT和Crouse积分的差异和相关性;入选患者均行冠状动脉造影术,根据判断冠状动脉粥样硬化病变情况将患者分为非冠心病组(60例)、单支病变组(44例)、双支病变组(56例)和多支病变组(36例),采用Gensini评分评判严重程度,观察各组之间Gensini评分的差异,并将IMT、Crouse积分与Gensini评分行相关性分析,得出颈动脉粥样硬化与冠心病严重程度的关系,从而得到颈动脉超声在冠心病严重程度评估中的应用价值。结果对照组与AMI组、UA组IMT值及Crouse积分比较差异有统计学意义(P<0.05),非冠心病组、单支病变组、双支病变组和多支病变组IMT值及Crouse积分组间比较差异有统计学意义(P<0.05),Crouse积分与Gensini评分具有相关性。结论颈动脉超声检查颈动脉粥样硬化的严重程度在冠心病严重程度的评估中具有重要应用价值。

Objective To investigate the application value of carotid artery ultrasound in severity degree evaluation of coronary heart disease. Methods Carotid artery ultrasound was applied to detect carotid artery intima-media thickness（IMT） and their Crouse scores of coronary heart disease patients（control group, n=60）, unstable angina pectoris（UA） patients（UA group, n=74） and acute myocardial infarction（AMI） patients（AMI group, n=62）. Difference and correlation between IMT and Crouse scores of the three groups were observed. All patients received coronary arteriography, and they were divided into non-coronary heart disease group（n=60）, single vessel disease group（n=44）, double vessel disease group（n=56）, and multivessel disease group（n=36）. Gensini score was applied to evaluate the severity degree. Differences of Gensini scores in those groups were observed. Correlation analysis was taken on IMT, Crouse scores and Gensini scores to show the relationship between carotid atherosclerosis and severity of coronary heart disease, so as to gain the application value of carotid artery ultrasound in severity degree evaluation of coronary heart disease. Results The difference of IMT and Crouse scores between the control group and AMI group, UA group had statistical significance（P〈0.05）. There was a statistical significant difference of IMT and Crouse scores in non-coronary heart disease group, single vessel disease group, double vessel disease group, and multivessel disease group（P〈0.05）. Crouse score was correlated with Gensini score. Conclusion Carotid artery ultrasound has important value in severity degree evaluation of coronary heart disease.