基于超声造影技术探讨颈动脉粥样硬化斑块与冠状动脉粥样硬化性心脏病的相关性

The correlation between carotid atherosclerosis and coronary heart disease based on contrast-enhanced ultrasound

目的应用超声造影技术研究颈动脉粥样硬化斑块新生血管与冠状动脉粥样硬化性心脏病(冠心病)的相关性.方法选择经冠状动脉造影确诊的112例冠心病患者为研究对象,其中,急性冠状动脉综合征(ACS)患者40例(ACS组),稳定型心绞痛(sCAD)患者72例(sCAD组).对2组患者分别进行颈动脉斑块常规超声检查与超声造影检查,采用时间-强度曲线(TIC曲线)分析软件对声像图进行脱机分析,统计2组患者斑块类型、斑块面积、斑块厚度及截面积狭窄率,计算2组患者最大软斑斑块增强强度、增强强度比值,分析斑块内新生血管与冠心病的相关性.结果 ACS组患者平均斑块面积为(0.48±0.14)cm^2,sCAD组为(0.49±0.11)cm^2,2组患者斑块面积比较差异无统计学意义(P>0.05);ACS组患者平均斑块厚度为(3.3±0.3)mm,sCAD组为(3.0±0.3)mm,2组患者斑块平均厚度比较差异无统计学意义(P>0.05);ACS组患者平均截面积狭窄率为(53±8)%,sCAD组为(52±7)%,2组患者平均截面积狭窄率比较差异无统计学意义(P>0.05).ACS组患者颈动脉斑块为软斑数量为30(33.3%),sCAD组患者颈动脉斑块为软斑数量为12(15.0%),2组比较差异具有统计学意义(P<0.05).ACS组最大软斑斑块增强强度及其比值为(12±3)dB和(0.7±0.3),sCAD组最大软斑斑块增强强度及其比值为(9±3)dB和(0.4±0.3),2组比较差异均具有统计学意义(P<0.01).结论超声造影技术评价颈动脉粥样硬化斑块内新生血管,能够作为ACS危险程度的预测指标之一.

Objective To explore the correlation between neovascularization of carotid atherosclerotic plaque and coronary heart disease by contrast-enhanced ultrasound. Methods One hundred and twelf cases of coronary heart disease diagnosed by coronary angiography were selected as subjects. Among them, 40 patients with acute coronary syndrome (ACS) were ACS group and 72 patients with stable angina (sCAD) were sCAD group. Ultrasound examination and contrast-enhanced ultrasound examination of carotid plaque in the two groups, using time-intensity curve (TIC curve) analysis software to get offline analysis of the sonogram. The plaque type, area, plaque thickness, and cross-sectional area stenosis rate of the two groups were statistically analyzed. Calculate the maximum soft plaque enhancement intensity and intensity ratio of the two groups of patients. The correlation between neovascularization in plaque and coronary heart disease was analyzed. Results The average plaque area was (0.48±0.14) cm^2 in the ACS group and (0.49±0.11) cm^2 in the sCAD group. There was no significant difference in plaque area between the two groups (P>0.05). The average plaque thickness of patients in the ACS group was (3.3±0.3) mm. The sCAD group was (3.0±0.3) mm, and there was no significant difference in the average plaque thickness between the two groups (P>0.05). The average stenosis rate was (53±8)% in the ACS group and (52±7%) in the sCAD group. There was no significant difference in the average stenosis rate between the two groups(P>0.05). The number of soft carotid plaques in the ACS group was 30(33.3%),and the number of soft carotid plaques in the sCAD group was 12(15.0%). The difference between the two groups was statistically significant (P<0.05). The maximum soft plaque enhancement intensity and its ratio in the ACS group were (12±3)dB and (0.7±0.3). The maximum soft plaque enhancement intensity and its ratio in the sCAD group were(9±3)dB and(0.4±0.3). Tht difference between the two group was statistical significance(P<0.01). Conclusion Contrast-enhanced ultrasound can be used as a predictor of ACS through quantitating carotid atherosclerosis plaque neovascularization.