冠状动脉粥样硬化性心脏病患者动脉粥样硬化性狭窄的临床特点分析

Clinical characteristics analysis of carotid artery stenosis in patients with coronary artery disease

目的分析颈动脉粥样硬化性狭窄(carotid artery stenosis,CS)与冠状动脉粥样硬化性心脏病(冠心病)的关系,探讨两者共患的临床特点。方法 102例经冠状动脉造影确诊为冠心病的患者住院期间行双侧颈动脉超声检查,根据冠状动脉狭窄累及情况分为单支、两支(含左主干病变)和三支病变组,以CS≥70%为切分点,比较CS在不同亚组间的发病情况及特点;采用多因素Logistic回归分析分析年龄、性别、原发性高血压(高血压)、糖尿病、吸烟、脑卒中病史、血脂浓度、体质量指数、左主干病变和冠状动脉多支病变与CS的关系。结果 102例冠心病患者中有36例CS≥70%,发生率为35.3%。CS的发生率随冠状动脉病变程度加重而增加(P<0.05)。多因素Logistic回归分析显示只有性别和冠状动脉多支病变是CS的独立危险因素(P<0.05)。结论冠心病患者伴发CS与冠状动脉病变严重程度相关,冠状动脉多支病变患者应常规进行颈动脉超声筛查。

Objectives To evaluate the clinical characteristics analysis of carotid artery stenosis(CS)in patients with coronary artery disease(CAD)and the relationship of CS and CAD.Methods Totally102patients with CAD were enrolled.Carotid duplex ultrasonography was performed in patients during hospitalization after coronary artery angiography.According to the involved vessels(coronary artery≥50%stenosis),patients were classified into three groups:group1with1-vessel involved,group2with2-vessel or left main stem(LMS)involved,group3with3-vessel involved.The clinical characteristics and distribution of CS in different groups was assessed by taking CS≥70%as a cutoff point.Age,sex,hypertension,diabetes,smoking history,stoke history,concentration of blood lipid,body mass index,LMS and multi-vessel lesions were recruited to indentify independent risk factors associated with significant CS using Logistic regression analysis.Results The overall incidence of CS≥70%was35.3%(36/102).Incidence of CS in patients with multi-vessel lesions was higher than those of patients with one vessel lesions and2-vessel or LMS(P<0.05).Only sex and multi-vessel lesions were found to be independently risk factors(P<0.05)for CS by multivariable Logistic regression analysis.Conclusions Patients with CAD had higher prevalence rates for CS when suffering from multi-vessel lesions,and carotid duplex ultrasonography is recommended for a routine examination.