周围血管动脉粥样硬化及冠状动脉粥样硬化相关性探究.docVIP

周围血管动脉粥样硬化及冠状动脉粥样硬化相关性探究 　【摘要】 目的 应用超声方法检测外周动脉内-中膜厚度（IMT）及斑块情况，探讨外周动脉与冠状动脉粥样硬化的相关性，评价超声检测外周动脉粥样硬化对冠状动脉病变的预测价值及其临床意义。方法 对110例天津医科大学第二医院心脏科住院行冠状动脉造影（CAG）的患者术后1～2周内，行外周动脉（包括颈总、颈内、颈外、股总、股浅、股深、腘、足背动脉）粥样硬化情况进行超声检查，以动脉IMT和粥样硬化斑块厚度作为观测指标，对各组病例外周动脉粥样硬化的情况进行比较，进行统计学分析，探讨动脉粥样硬化发生的危险因素，外周动脉与冠状动脉粥样硬化的相关性。结果 （1）CCA IMT、颈动脉IMT、CFA IMT、SFA IMT、DFA IMT、下肢动脉IMT在冠脉未见异常组与其余三组任一组均差异有统计学意义（P＜0.05），冠脉未见异常组IMT值小于其余三组。（2）随着冠状动脉粥样硬化血管的数量增加，颈动脉和下肢动脉动脉粥样硬化情况加重，斑块形成呈明显增加趋势。（3）多因素Logistic回归分析（STEPWISE），CFA IMT和P下肢与冠状动脉粥样硬化具有显著相关性，有统计学意义（P＜0.05）。结论 （1）颈动脉、下肢动脉和冠状动脉粥样硬化的趋势一致。（2）颈部和下肢血管的IMT及斑块对冠状动脉粥样硬化有很好的预测价值；P下肢、CFA IMT可作为预测冠状动脉粥样硬化的重要指标。（3）年龄、吸烟时间、患有高血压及高血压患病时间、甘油三酯、空腹血糖、胰岛素水平是动脉粥样硬化的高危因素。 【关键词】 动脉粥样硬化；外周动脉；超声；冠状动脉造影 ［Abstract］ Objective Examining peripheral arteries with ultrasound and describing the extent of atherosclerosis with IMT and plaque，to investigate the correlation of peripheral arteries atherosclerosis and coronary artery atherosclerosis，evaluate the predicting value of peripheral arteries with ultrasound to coronary artery atherosclerosis and clinical value.Methods One hundred and ten patients were examined by ultrasound after coronary angiography of 1～2 weeks，observing the intima-media thickness and plaque condition of common carotid artery，internal carotid artery，external carotid artery，carotid bifurcation，common femoral artery，superficial femoral artery，deep femoral artery，popliteal artery，dorsalis pedis artery，measuring and recording IMT，thickness of the atherosclerotic plaque，and stenosis extent of different arteries.According to coronary angiography，all patients were classified into four groups.Contrasting the atherosclerotic pathology of four groups，to study the risk factors of atherosclerosis，the correlation of peripheral artery atherosclerosis and coronary artery atherosclerosis.Results （1）Statistical significances of CCA IMT，carotid artery IMT，CFA IMT，SFA IMT，DFA IMT，lower limbs arteries IMT were inferred at P＜0.05 between the group with normal coronary arteries and any