急性冠脉综合征患者颈动脉斑块检测的临床意义

Clinical significance of detection of carotid artery plaque in patients with acute coronary syndrome

目的研究急性冠脉综合征(ACS)患者颈动脉中层内膜厚度和斑块积分及与血清高敏C反应蛋白的相关性。方法采用彩色多普勒超声显像仪检测30例ACS患者、29例稳定性心绞痛患者和17例正常对照颈动脉中层内膜厚度和斑块积分,以及测定血清高敏C反应蛋白。结果3组间年龄、性别、总胆固醇、甘油三脂、高脂蛋白胆固醇和低密度脂蛋白胆固醇差异无显著性。ACS组颈动脉内膜中层厚度、总斑块积分、软斑块积分、硬斑块积分显著高于稳定性心绞痛组和对照组。ACS组高敏C反应蛋白[(4.336±1.334)mg/L]显著高于稳定性心绞痛组[(2.205±0.458)mg/L]和正常对照组[(1.625±0.434)mg/L],差异有显著性意义。血清高敏C反应蛋白与总斑块积分、软斑块积分、硬斑块积分和颈动脉内膜中层厚度呈正相关。结论ACS患者颈动脉内膜中层厚度、总斑块积分、软斑块积分、硬斑块积分和高敏C反应蛋白升高显著高于稳定性心绞痛组和对照组,血清高敏C反应蛋白与总斑块积分、软斑块积分、硬斑块积分和颈动脉内膜中层厚度呈正相关。

Objective To study the intima-media thickness (IMT), plaque score in the carotid artery of patients with acute coronary syndrome (ACS) and the relationship between high-sensitivity C-reactive protein (hs-CRP) and the plaque score. Methods Using high-resolution ultrasonic instrument, IMT and the plaque score in the carotid artery were detected in 30 patients with ACS, 29 patients with stable angina pectoris(SAP) and 17 control subjects, in addition to the measurement of hs-CRP. Results Compared with SAP and control groups, IMT, total plaque score, soft and hard plaque scores in the carotid artery in ACS group were significantly increased (P<0.001). Hs-CRP (4.336±1.334 mg/L) in ACS group were significantly increased (P<0.001) as compared with that in SAP group (2.205±0.458 mg/L) and control group (1.625±0.434 mg/L). Hs-CRP had positive relationship with the IMT, whole plaque score, soft and hard plaque scores in the carotid artery, respectively. Conclusion IMT, total plaque score, soft and hard plaque scores in the carotid artery in ACS group are significantly increased, and hs-CRP is positively related to IMT, total plaque score, soft and hard plaque scores in the carotid artery, respectively.