超声测定颈动脉内中膜厚度与动脉弹性对冠心病病变程度的评估价值

Value of ultrasonic measurement of carotid intima-media thickness and arterial elasticity for assessment of coronary heart disease severity

目的:研究超声测定颈动脉内中膜厚度对动脉弹性对冠心病病变程度的评估价值。方法:选择冠心病心绞痛患者作为CHD组、健康体检者作为对照组,行颈动脉超声检查并测定颈动脉内中膜厚度(IMT),采集血清并测定脂质代谢指标、黏附分子、趋化因子的含量。结果:CHD组IMT显著高于对照组且CHD组中多支血管病变患者的颈动脉IMT显著高于单支血管病变;CHD组中颈动脉IMT增厚和斑块患者的血清LDL、ox-LDL、ApoB、PCSK9、RANTES、FKN、MCP-1、CCL21、CXCL16、ICAM-1、VCAM-1、LFA-1、P-选择素、E-选择素含量显著高于颈动脉IMT正常患者,CHD组中颈动脉IMT斑块患者的血清LDL、ox-LDL、ApoB、PCSK9、RANTES、FKN、MCP-1、CCL21、CXCL16、ICAM-1、VCAM-1、LFA-1、P-选择素、E-选择素含量显著高于颈动脉IMT增厚患者。结论:超声测定颈动脉IMT、动脉弹性能够为冠心病病变程度的评估提供依据且颈动脉IMT、动脉弹性与脂质代谢异常、黏附分子和趋化因子含量改变密切相关。

Objective： To study the value of ultrasonic measurement of carotid intima-media thickness and arterial elas- ticity for assessment of coronary heart disease severity. Methods： Patients with coronary heart disease angina were selected as CHD group, healthy subjects were selected as control group, carotid artery ultrasonography was conducted to determine carot- id intima-media thickness （IMT）, and serum was collected to determine serum content of lipid metabolism indexes, adhesion molecules and chemokines. Results： Carotid IMT of CHD group was significantly higher than that of control group and the ca- rotid IMT of patients with multi-vessel disease in CHD group was significantly higher than that of patients with single-vessel disease; LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with thickened carotid IMT and carotid plaque in CHD group were significantlyhigher than those of patients with normal carotid IMT, and LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with carotid plaque in CHD group were significantly higher than those of patients with thickened carotid IMT. Conclusion： Ultrasonic measurement of carotid IMT and arterial elasticity can provide the basis for assessment of coronary heart disease severity, and the carotid IMT and arterial elasticity are closely related to the abnormal lipid metabolism as well as the changes in the content of adhesion mol- ecules and chemokines.