颈动脉内膜中层厚度与冠心病的相关性分析

The relationship between carotid intima-media thickness and crononary heart disease

目的:探讨颈动脉内膜中层厚度(IMT)与冠心病的关系及IMT与冠脉病变程度的相关性。方法:对248例疑似冠心病患者行彩色多普勒超声测定颈动脉IMT,经冠脉造影分为冠心病组158例和非冠心病组(对照组)90例,158例冠心病患者按冠脉造影结果分为3个亚组:单支病变组48例,双支病变组44例,三支病变组66例。比较组间颈动脉IMT及冠脉病变Gensini积分的差异,分析颈动脉IMT与冠脉病变支数及冠脉病变Gensini积分的关系。采用多元线性回归分析冠心病的危险因素。结果:冠心病组的颈动脉IMT[(1.13±0.35)mm vs.(0.93±0.29)mm]及冠脉病变Gensini积分[(20.43±1.32)分vs.(0.39±0.04)分]均高于对照组,差异有统计学意义(t=11.09、9.578,P<0.01)。冠心病多支病变组(双支及三支病变组)的颈动脉IMT及冠脉病变Gensini积分均高于单支病变组,且三支病变组的Gensini积分高于双支病变组,差异有统计学意义(P<0.01)。颈动脉IMT与冠脉病变支数及冠脉病变Gensini积分呈正相关(r=0.31、0.46,P<0.01)。多元线性回归分析发现颈动脉IMT增厚(OR=3.18)、尿酸水平较高(OR=4.08)、有吸烟史(OR=2.93)是冠心病的独立危险因素。结论:颈动脉IMT与冠心病及冠脉病变程度密切相关,采用超声检测颈动脉IMT早期预测冠心病及冠脉病变程度有一临床意义。

Objective:To investigate the relationship between carotid intima-media thickness(IMT)and coronary heart disease(CHD).Methods:The carotid IMT was measured by B ultrasound,then all the patients were divided into CHD group(158 cases)and the control group(without CHD,90 cases).And 158 patients with CHD were divided into three subgroups according to the results of coronary angiography:48 patients with single vessel disease,44 patients with double vessel disease and 66 patients with three vessel disease.The differences of IMT and Gensini score of carotid artery lesions between groups were compared,and the relationship between IMT of carotid artery and the number of lesion branches of coronary artery and Gensini score of coronary artery lesions was analyzed.Multivariate linear regression was used to analyze the risk factors of CHD.Results:The IMT of carotid artery[(1.13±0.35)mm vs.(0.93±0.29)mm]and Gensini score of coronary artery lesion[(20.43±1.32)vs.(0.39±0.04)score]in CHD group were higher than those in control group,and the difference was statistically significant(t=11.09,9.578,P<0.01).The IMT of carotid artery and Gensini scores of coronary artery lesion in multi-vessel lesion group(double vessel lesion group and three vessel lesion group)were higher than those in single vessel lesion group,and the Gensini score of three vessel lesion group were higher than that of double vessel lesion group(P<0.01).There is a significant positive correlation between carotid artery IMT and the number of coronary stenosis and the degree of coronary stenosis(r=0.31,0.46,P<0.01).Multivariate linear regression analysis showed that carotid IMT thickening(OR=3.18),high uric acid level(OR=4.08)and smoking history(OR=2.93)were independent risk factors for CHD.Conclusions:Carotid IMT is closely related to the severity of CHD and coronary artery lesion.It is of clinical significance to detect carotid IMT early in predicting the severity of CHD and coronary artery lesion.