颈动脉内-中膜厚度对冠状动脉病变的预测价值

The Predictive Value of Carotid Intima-media Thickness for Coronary Artery Disease

目的:探讨颈动脉内-中膜厚度对冠状动脉病变的预测价值。方法:根据冠状动脉造影结果,将183例行冠状动脉造影的患者分为3组:正常组59例为冠状动脉造影阴性;A组54例冠状动脉狭窄率<50%;B组70例冠状动脉狭窄率≥50%。根据冠状动脉病变数量将124例冠状动脉狭窄的患者进一步分为单支病变组40例,双支病变组38例和多支病变组46例。所有患者行颈动脉超声检查,测量颈动脉内-中膜厚度。结果:A组、B组的颈动脉内-中膜厚度和冠脉积分(Gensini评分)均明显高于正常对照组,且B组颈动脉内-中膜厚度和Gensini评分均较A组明显增加,差异均有统计学意义(P<0.05)。随着冠状动脉狭窄程度的加重,颈动脉内-中膜厚度和Gensini评分逐渐增加。多支病变组、双支病变组IMT值和Gensini评分均显著高于单支病变组(P<0.05),而双支病变组与多支病变组比较差异均无统计学意义(P>0.05)。颈动脉IMT厚度与冠状动脉病变数量相关性不大,与Gensini评分呈显著性正相关(P<0.01)。结论:颈动脉内-中膜厚度能较好地预测冠状动脉病变程度,但不能预测冠状动脉病变范围。

Objective： To investigate the predictive value of carotid intima-media thickness（IMT） for coronary artery disease.Methods： 183 patients who had taken coronary angiography（CAG） were studied. These patients were divided into 3 groups based on the results of CAG： normal group（n=59, no stenosis）, group A（n=54, stenosis〈50 %）, group B（n=70, stenosis≥50 %）. Patients with stenosis（n=124） were further divided into 3 groups： single lesion group（n=40）, double lesions group（n=38）, multiple lesions group（n=46）.Ultrasonography was used to measure the IMT in carotid arteries. Results： Carotid intima-media thickness and Gensini scores of group A and group B were both significantly higher than those of normal group; IMT and Gensini scores of group B were significantly higher than those of group A（P〈0.05）. With the aggravating severity of coronary artery stenosis, IMT and Gensini scores increased gradually. IMT and Gensini scores of double lesions group and multiple lesions group were markedly higher than single lesion group. But there was no significantly different between double lesions group and multiple lesions group（P〉0.05）. Little correlation was found between carotid IMT and the numbers of coronary artery disease. With the increase of coronary artery lesion number, carotid IMT showed an increasing trend. Gensini scores were positively correlated with carotid IMT（P〈0.01）. Conclusions： Carotid intima-media thickness had good predictive value for the severity of coronary artery disease, but cannot reflect the extent of coronary artery stenosis.