冠状动脉病变与弓上动脉颅内外段病变相关性探讨

Relationship between the lesions of coronary artery and the upper-aortic arteries stenosis

目的利用心脑血管联合造影分析冠状动脉与弓上动脉(包括颈内动脉颅外段及颅内段、椎动脉颅外段及颅内段)病变的相关性。方法对怀疑冠状动脉粥样硬化性心脏病(coronary artery disease,CAD)且颈动脉彩超或经颅多普勒或脑血管增强CT检查提示存在弓上动脉狭窄的180例患者进行同期或分期心脑血管联合造影检查,根据冠状动脉造影(coronary angiography,CAG)结果,将患者分为两组:1)非CAD组:冠状动脉狭窄<50%;2)CAD组:冠状动脉狭窄≥50%,分析冠状动脉病变情况与弓上动脉各段病变的关系,用Logistic回归模型评价二者的相关性。结果颈动脉颅内段、颈动脉颅外段及椎动脉颅内段狭窄在CAD与非CAD组差异均无统计学意义(P=0.166、0.146、0.128);椎动脉颅外段狭窄在CAD组发病率明显高于非CAD组(P=0.010)。结论冠状动脉病变可能与椎动脉颅外段病变密切相关。

Objective To explore the relationship between atherosclerotie heart disease and eerebrovascular disease through cardiac and cerebral angiography, to analyze the distribution characteristics of intracranial and extracranial sections lesions of upper-aortic arteries in patients with coronary artery disease （CAD）. Methods According to the result of the coronary angiography （CAG）, 180 patients who were suspected to have coronary heart disease were divided into non-CAD group and CAD group. Cerebral angiography was performed in all patients, and all patients also provided information about physical history, age, sex, body mass index （BMI）, smoking, and the results of blood routine tests, glycosylated hemoglobin, coagulation function, high sensitivity C-reactive protein （ hs-CRP）, homocysteine （HCY） and biochemical test were analyzed and the relationship between the lesions of coronary artery lesions and intracranial, extracranial sections of upper-aortic artery was explored, and the correlation of the two groups of subjects was analyzed with logistic regression model. Results There was no significant difference between CAD and non-CAD group in the intracranial carotid, extracranial carotid and intracranial vertebra（P = 0. 166,0. 146,0. 128 ）. The incidence of extracranial vertebral artery stenosis in CAD group were significantly higher than that of non-CAD group （P = 0. 010）. Conclusion Coronary artery lesions may be closely related to eXtraCranial vertebral artery lesions.