冠心病患者颈动脉内膜中层厚度及颈动脉斑块与SYNTAX评分的相关性研究

Correlation Study of Carotid Intima-media Thickness,Carotid Plaques and SYNTAX Score in Patients with Coronary Heart Disease

目的：探讨冠心病患者颈动脉内膜中层厚度（CIMT ）及颈动脉斑块与冠状动脉SYNTAX评分的关系。方法选择行冠状动脉造影的患者256例，根据冠状动脉造影结果分组：51例冠状动脉狭窄＜50％为对照组，余205例为冠心病组。冠心病组又根据SYNTAX评分结果分为低分组（1-22分）70例、中分组（23-32）94例、高分组（＞32分）41例。所有患者均采用超声检测双侧CIMT及颈动脉斑块情况。结果与对照组比较，冠心病组患者CIMT及斑块发生率明显高于对照组（ P＜0.05）。与低分组比较，中分组和高分组CIMT及斑块发生率明显升高（ P＜0.05）。Spearman线性回归分析结果显示冠心病患者CIMT与SYNTAX评分呈直线正相关（ r＝0.64，P＜0.01）。多因素Logistic回归分析结果显示，CIMT及颈动脉斑块是SYNTAX积分＞32分的独立预测因素（ P＜0.05）。结论 CIMT及颈动脉斑块与冠心病患者SYNTAX评分密切相关，可间接预测冠状动脉病变严重程度。

Objective To explore the association of carotid intima_media thickness （CIMT ） ,carotid plaques with SYNTAX score of coronary artery in patients with coronary heart disease（CHD）. Methods 256 patients who underwent coronary arteriography （CAG） were divided into control group with their coronary stenosis 〈50% （n=51）and CHD group（n=205）.According to SYNTAX score , CHD group was further divided into low score group （n=70 ,1-22scores） ,intermediate score group （n=94 ,23-32scores） and high score group （n=41 ,〉32scores）.CIMT and catotid plaques were evaluated with ultrasonic inspection and measurement in all patients. Results Incidence rates of elevated CIMT and carotid plaques were significantly higher in CHD group than in the control group （ P〈0.05）.Incidence rates of elevated CIMT and carotid plaques were significantly higher in intermediate score group （23-32scores） and high score group （〉32scores） than in the low risk group （1-22scores）. The Spearman linear_regression analysis showed that SYNTAX scores had a positive correlation with CIMT （ r=0.64 ,P〈0.01 ）. Multivariate logistic regression analysis showed that CIMT and carotid plaques were the independent predictive factors for coronary artery lesion with SYNTAX score〉32 （ P〈0.05）.Conclusions CIMT and carotid plaques were closely associated with SYNTAX scores in patients with CHD ,which could be used to indirectly predict the severity of coronary artery lesion.