超声造影颈动脉斑块增强强度与冠心病临床分型的相关性研究

Correlation between the enhanced intensity of carotid plaque by contrast-enhanced ultrasound and the clinical classification of coronary heart disease

目的探讨颈动脉斑块回声及造影增强强度与冠心病(CHD)临床分型的相关性。方法选取颈动脉斑块患者99例,其中30例为非CHD组,稳定性心绞痛(SAP)、不稳定性心绞痛(UA)组各30例,急性心肌梗死(AMI)组9例。用二维超声记录颈动脉斑块厚度及回声,超声造影检测厚度>2 mm的均质低回声或非均质型斑块造影增强的强度。结果SAP组和非CHD组低回声斑块所占比例明显低于UA组(χ^2=7.937,9.932,P<0.05);UA组患者超声造影增强比例(90.9%)高于SAP组患者(40%,)2组比较差异有统计学意义(Z=2.596,P<0.05);UA组患者超声造影增强强度的总体分布不同于AMI组(Z=1.964,P<0.05),二者差异有统计学意义。结论颈动脉斑块的回声类型以及造影增强强度均与冠心病临床分型有一定的关联,是预测UA和AMI发生的一种较可靠的诊断技术。

Objective To discuss the correlation between the echo types and contrast-enhanced intensity of carotid plaques and the clinical classification of coronary heart disease(CHD).Methods 99 patients with carotid plaque were selected,30 of them were none CHD patients,30 of them were stable angina(SAP),30 of them were unstable angina(UA),and 9 of them were acute myocardial infarction(AMI).Two-dimensional ultrasound was used to record the carotid plaque thickness and echo,and contrast-enhanced ultrasound(CEUS)was used to detect the enhancement intensity of homogeneous hypoechoic or heterogeneous plaques with>2 mm thickness.Results The proportion of hypoechoic plaques in SAP group(χ^2=7.937,P<0.05)and none CHD group(χ^2=9.932,P<0.05)was significantly lower than that in UA group.The proportion of enhanced plaques in UA group was 90.9%(20/22),higher than that in SAP group(40%,2/5)(Z=2.596,P<0.05).The overall distribution of CEUS enhanced intensity in UA group was different from that in AMI group(Z=1.964,P<0.05).Conclusion The echo type and contrast-enhanced intensity of carotid plaque are related to the clinical classification of coronary heart disease,which is a reliable diagnostic technique for predicting the occurrence of UA and AMI.