颈动脉结构改变与冠状动脉病变关系的研究

The Study of the relationship between Canary artery atherosderosis and the structural changes in common carotid artery

目的评价颈动脉结构的改变与冠状动脉病变及其严重程度的关系。方法根据冠状动脉造影结果,将152名临床怀疑或已确诊为冠心病的患者(男性119名,女性33名)分为冠心病组(117人)和正常对照组(35人),用高分辨率超声心动仪检测所有患者的双侧颈动脉(CCA)内径、内中膜厚度(IMT)、斑块及其数量,计算几何形状改变(R/IMT)。用SPSS 10.0软件进行数据分析。结果颈动脉斑块发生率、内径、IMT、颈动脉半径和IMT的比值(R/IMT)均和年龄增长显著相关。冠心病患者的CCA斑块发生率、斑块数和IMT显著高于正常对照组(P值分别为0.000、0.001和0.007),R/IMT显著低于对照组(P=0.000),斑块对诊断冠心病敏感性为74.1％,特异性为71.4％,OR=7.167;CCA斑块发生率和斑块数在多支冠脉病变者显著高于单支病变者(P=0.000及P=0.004),CCA斑块发生率(r=0.098,P=0.050)和IMT(r=0.258,P=0.003)和冠脉Gensini积分显著相关。结论颈动脉结构改变与年龄增长显著相关。CCA斑块、IMT对预测冠心病危险性有益。

Objective To study the relationship among the structural changes measured by ultrasonography of common carodd artery (CCA) and the risk and severity of CAD. Methods 152 patients (117 men and 35 women) with clinical suspected or diagnosed for CAD were divided to CAD group (117 patients) and controll group (35 patients) by the results of coronary angiography. Measuring bilateral CCA diameter, ultima- media thickness (IMT), Plaques and it' s number. Data analysis were employed SPSS10.0. Results The prevalence of CCA plaque, number of plaque and IMT of CAD patients were significantly higher than that of controll (P = 0.000, 0.001, and 0.007, respectively), and R/IMT of CAD patients was significantly lower than that of controll (P = 0.000) . When plaque was employed for diagnosing CAD, it' s sensitivity was 74.1%, and speciality was 71.4%, and oR was 7.167. The prevalence of CCA plaque, number of plaque of two - or three - vessel disease were significantly higher than that of single - vessel disease (P= 0.000, and 0.004), respectively The prevalence of CCA plaque (r = 0.098, P= 0.050), IMT (r = 0.258, P= 0.003) were significantly corelated with Gensini' s score. Conclusions the structural changes of CCA were significantly corelated with age. The prevalence of CCA plaque, number of plaque and IMT can predict the risk of CAD.