彩色多普勒超声检测动脉内中膜厚度、血管舒张功能在预测冠心病发生中的价值

Value of color Doppler ultrasound in detection of carotid intima-media thickness and vascular diastolic function for prediction of coronary heart disease

目的分析彩色多普勒超声检测动脉内中膜厚度、血管舒张功能在预测冠心病发生中的应用价值。方法选取心绞痛患者80例进行冠脉造影,根据冠脉造影结果分为冠心病组43例与非冠心病组37例。对所有患者进行冠状动脉造影和动脉超声检查,比较2组患者的性别、年龄、体质量指数(BMI)、收缩压和舒张压、高血压病、糖尿病、高脂血症和吸烟史、颈动脉中膜厚度(IMT),E峰(EPFV)和A峰(APFV)等。结果 2组性别、年龄、吸烟、饮酒、收缩压、舒张压、心率、BMI、颈动脉IMT和股浅动脉IMT比较无显著差异(P> 0. 05)。单支、双支和三支冠心病组中的颈动脉IMT值都高于非冠心病组,股浅动脉IMT值都高于非冠心病组,差异有统计学意义(P <0. 05)。单支、双支和三支冠心病组颈动脉IMT和股浅动脉IMT比较都有显著差异(P <0. 05)。颈动脉IMT值显著高于股浅动脉IMT(P <0. 01),颈动脉IMT是冠脉Gensini积分的独立影响因素。冠心病组EPFV、E峰与A峰比值(E/A)显著低于非冠心病组,APFV显著高于非冠心病组(P <0. 05)。结论颈动脉内IMT的彩色多普勒超声检测在预测冠心病病变程度方面优于股浅动脉IMT,IMT和E/A比值是冠心病病变程度的良好评价指标。

Objective To analyze value of color Doppler ultrasound in detection of carotid intima-media thickness and vascular diastolic function for prediction of coronary heart disease. Methods A total of 80 stenocardia cases underwent coronary angiography were randomly divided into coronary heart disease group ( n =43), and non coronary heart disease group( n =37) according to the results of coronary angiography. All patients underwent coronary angiography and arterial ultrasound examination. The sex, age, body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), the history of hypertension (HBP), diabetes mellitus, hyperlipidemia and history of smoking, carotid intima-media thickness (IMT), E peak (EPFV) and A peak(APFV) of two groups were analyzed. Results Gender, age, smoking, alcohol drinking, systolic blood pressure, diastolic blood pressure, heart rate, BMI, carotid IMT and superficial femoral artery IMT showed no significant difference between CHD and non CHD group ( P >0.05). Values of carotid artery IMT, and superficial femoral artery IMT in single branch, double branches and three branches of the coronary heart disease group were higher than that of non CHD group ( P <0.05), Value of carotid artery IMT was higher than superficial femoral artery IMT( P <0.01), and carotid artery IMT was an independent influencing factor for coronary artery Gensini scores. CHD group had lower EPFV, E peak, and ratio of E peak to A peak(E/A), and higher APFV than non CHD group ( P <0.05). Conclusion The color Doppler ultrasound of carotid artery IMT is superior to the superficial femoral artery IMT, the ratio of IMT to E/A, and it can better predict the degree of coronary heart disease.