联合检测颈动脉粥样斑块及hsCRP对冠心病患者冠脉狭窄程度评.doc

联合检测颈动脉粥样斑块及hsCRP对冠心病患者冠脉狭窄程度评 　 作者：盛洋 付强 李振勇 陆奕 【摘要】 目的： 探讨颈动脉内中膜厚度(intimamedia thickness，IMT)、颈动脉粥样斑块Crouse积分联合超敏C反应蛋白(high sensitivity C reactive protein，hsCRP) 血清浓度对冠心病患者冠脉狭窄程度的预测价值。方法： 110例因胸闷、痛而疑是冠心病的入院患者1周内行冠状动脉造影、颈动脉超声检查，入院第2日进行hsCRP血清浓度检测，依据冠状动脉造影(coronary angiography,CAG)结果分为冠心病组和正常对照组。评估三者联合检测的预测价值。结果： 冠心病组血清hsCRP浓度、颈动脉斑块IMT，Crouse积分均明显高于正常对照组(Plt;0.01)，且各指标检测值的大小与冠脉狭窄程度均成正相关(r均gt;0.6，Plt;0.05)。如将Crouse积分≥10.7作为标准，则其灵敏度为78.5%，阳性预测值89.9%，Crouse积分lt;10.7的特异度79.0%，阴性预测值58.0%。结论： 冠心病患者颈动脉粥样硬化斑块的IMT，Crouse积分联合血清hsCRP浓度与冠状动脉造影所示冠脉狭窄程度具有较高的一致性，其可作为对冠心病患者血管狭窄程度的一项预测方法。 【关键词】 冠心病; 颈动脉粥样斑块; 超敏C反应蛋白 　　[Abstract] Objective: To study the predictive value of score of intimamedia thickness(IMT),Crouse in carotid artery plaque, and serum levels of high sensitivity Creactive protein(hsCRP) in the degree of coronary stenosis of patients with coronary artery disease. Methods： A total of 110 patients suspected coronary heart disease with chest pain were admitted to this study. They were divided into two groups: group of coronary heart disease and group of normal control according to the results of CAG. All patients underwent carotid ultrasonography within a week，and carried out the testing of serum concentrations of hsCRP in second hospitalized day， to assess the determining and forecasting value of score of IMT and Crouse in carotid artery plaque, combining with serum levels of hsCRP in the degree of coronary stenosis of patients with coronary artery disease. Results： Serum concentrations of hsCRP,score of IMT, Crouse of group CHD were significantly higher than those of group nonCHD(Plt;0.01), and each mentioned indicators in group CHD was positively correlated with the degree of coronary stenosis(rgt;0.6， Plt;0.05). Taking Crouse points ≥10.7 as a standard，its sensitivity was 78.5%, positive predictive value was 89.9%, specificity was 79.0%, negative predictive value was 58.0%. Conclusion： There was a high consistency between serum concentrations