颈动脉易损斑块与冠脉SYNTAX积分的相关性研究

Study on the Correlation between Carotid Vulnerable Plaque and Coronary SYNTAX Score

目的:研究颈动脉易损斑块与冠脉SYNTAX积分的相关性,探讨颈动脉易损斑块及颈动脉粥样硬化(As)的指标对冠心病患者SYNTAX积分及疾病预后的预测效果。方法:选取2016年3月至2017年5月,于承德市中心医院心内科行冠脉造影的患者315例为研究对象,根据造影图像计算SYNTAX积分并分为四组:(1)轻度组(1≤积分<21)124例,(2)中度组(21≤积分<31)63例,(3)重度组(31≥积分)45例,(4)对照组(0分)83例;同时超声检测患者颈动脉As情况,测量、记录易损斑块数目、质地并进行相应评价。结果:(1)比较四组颈动脉易损斑块检出率,对照组与轻度组相比、中度组与重度组相比差异有统计学意义(P<0.05)。(2)比较四组颈动脉易损斑块占比情况,组间两两比较,对照组与轻度组、轻度组与中度组、中度组与重度组之间比较均有统计学意义(P<0.05)。(3)随着SYNTAX积分增高,低回声为主的混合回声斑块占比在各组中呈梯状增高;除重度组外的其余三组,高回声为主混合回声斑块在各组中占比逐步增高;均质性斑块无明显统计学意义(P>0.05)。(4)随访患者出院后1个月愈后情况,差异无统计学意义(P>0.05)。结论:颈动脉易损斑块尤其是低回声为主的混合回声斑块与冠脉病变有显著相关性,超声检测颈动脉易损斑块对冠心病患者的早期诊断及预防有较大临床价值,值得深入挖掘。

Objective： To study the relationship between the vulnerable plaque （）i carotid artery and the coronary SYNTAX score, and to explore the predictive effect ol carotid atherosclerosis index on SYNTAX score and prognosis in patients with coronary heart disease. Methods： 315 cases underwent coronary angiography in Chengde central hospital from March 2016 to May 2017 were enrolled in the study. And the SYNTAX score was calculated according to coronary angiography,and divided into four groups ： mild group （ 1 ^ points 〈 2 1 ） in 124 cases, moderate group （21^ points 〈31） in 63 cases,severe group （more than or equal to 31 points） in 45 cases,the control group of 83 cases （0）; At the same time,the situation of carotid artery atherosclerosis was detected by ultrasound,and the n u m b e r and texture of vulnerable plaques were measured and recorded, and the corresponding evaluation was made. Results ： T he detection rate ol vulnerable plaque ol carotid artery was compared between the four groups. Compared with the mild group,the control group had a significant difference compared with the severe group （ P〈0.05）. The proportion of vulnerable plaque in carotid artery was compared between the four groups. There was a significant difference between the groups （ P〈0.05）. As SYNTAX score increased, mixed plaques hypoechoic accounted ladder in each group except the severe group increased; the other three groups,high echo mixed echo plaque in each group in proportion gradually in-creased ;plaque heterogeneity was not statistically significant （ P〉0.05）. There was no significant difference between the follow-up patients after 1 months of follow-up after discharge （P〉0.05）. Conclusion： Carotidvulnerable plaques, especially low echo mixed echo plaques are significantly correlated with coronary artery le-sions. Ultrasound detection ol vulnerable carotid plaques has great clinical value lor early diagnosis and pre-vention ol coronary heart disease, and it is worthy ol further excavation.