冠心病患者颈动脉粥样硬化及血管内皮舒张功能的临床研究.docVIP

冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床研究 　　作者：王义成 袁桂莉 赵九安 作者单位：(1.河北北方学院附属第一医院超声科，河北 张家口 075000;2.河北北方学院附属第一医院心内科，河北 张家口 075000) 　　【摘要】 目的： 研究冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床意义。方法： 采用高频超声测量冠心病组和对照组颈动脉斑块积分、斑块数、颈动脉内mdash;中膜厚度(IMT)及血管内皮舒张功能(EDD%)，并进行对比分析。结果：1.冠心病组颈动脉IMT、斑块积分及斑块数明显高于对照组，多支冠脉血管病变组明显高于单支病变组;2.冠心病组内皮舒张功能明显低于对照组，单支、双支病变组间无显著性差异。3.冠状动脉造影与颈动脉超声结果比较，以斑块存在为预测冠脉病变的阳性指标，敏感性为83%、特异性75%。结论: 冠心病患者多合并血管舒张功能受损及颈动脉粥样硬化，高频超声探查颈动脉可预测冠状动脉病变的存在及严重程度。 　　【关键词】 冠心病; 血管内皮舒张功能; 颈动脉粥样硬化 　　基金项目：河北省科学技术研究与发展指导计划项目(编号：20042761457) 　　Clinical Study on Carotid Arterosclerosis and Endothelium 　　dependent Dilation in Coronary Heart Disease 　　WANG Yicheng, YUAN Guili,ZHAO Jiuan 　　Department of Ultrasound Diagnostics，The First Affilicated Hospital， 　　Hebei North University,Zhangjiakou,075000,Hebei,China 　　【ABSTRCT】 Objective: To investigate the clinical significance of the carotid arterosclerosis and endotheliumdependent dilation(EDD%) in coronary heart disease. Methods: The intimamedia thickness(IMT), Crouse scores and numbers of plaque in carotid artery and endotheliumdependent dilation were measured by highfrequency ultrasound in patients with coronary artery disease and control group.The rersults were analyzed and compared. Results: There were significant differences in carotid artery IMT value,Crouse scores and 　　numbers of plaque among the control,onevessel stenosis and multivessel stenosis groups. There were significant differences in EDD% between control group and coronary artery disease group.There was no difference between onevessel stenosis and multivessel stenosis groups.The sensitivity and specificity of predicting the coronary artery atherocslerosis by the carotid plaque were 83% and 75%.Conclusion: Carotid artery atherosclerosic lesions and EDD% can predict the existence and severity of the coronary artery atherosclerosis. 　　【KEY WORDS】 Coronary heart disease; Endotheliumdependent Dilation;Carotid arterosclerosis 　　动脉粥样硬化是一种慢性、进行性、影响