超声检查颈动脉内中膜厚度对预测冠心病应用价值.docVIP

超声检查颈动脉内中膜厚度对预测冠心病应用价值 　　【摘要】 目的 探讨超声检测颈动脉内中膜厚度(IMT)及动脉粥样硬化斑块的形成对冠状动脉病变预测的价值。方法 对160例疑似冠心病的患者行颈动脉的超声及冠状动脉造影检查,按冠状动脉造影结果将患者分为对照组(无冠心病组38例)和总冠心病组(单支病变46例,双支病变40例,3支病变36例)。结果 对照组及冠心病组颈动脉内中膜厚度(IMT)及斑块发生率相比,差异有统计学意义(P0.01);随着冠状动脉病变严重程度的增加,颈动脉内膜中层厚度和斑块发生率随之增高,差异均有统计学意义(P0.05)。结论 颈动脉粥样硬化与冠心病有明显相关性,颈动脉血管彩色多普勒超声检查可用于预测冠状动脉粥样硬化的病变程度。 　　【关键词】 冠心病;颈动脉粥样硬化;冠状动脉造影术;彩色多普勒超声检查 　　 　　Application value of carotid intimamedia thickness ultrasound in prediction of coronary heart disease 　　DU Shenglong.Department of Ultrasonics, Hospital of Shandong Rongjun, Jinan, Shandong 250013, China 　　【Abstract】 Objective To investigate the predictive value of the carotid atherosclerosis for coronary artery disease (CAD) with ultrasound.Methods 160 patients with suspected CHD performed carotid artery ultrasonography and coronary angiography.The patients weredivided into control group (38 cases of no coronary heart disease) and total coronary heart disease group (46 cases of single vessellesion, 40 cases of double vessel lesion, 36 cases of triple vessel lesion).Results Comparing the carotid intimamedia thickness( IMT) and plaque incidence between control group andcoronary heart disease group, the differences were significant(P0.01) ; Intimamedia thickness and incidence rate of plaque of neck artery increased with the increasing of coronary artery lesion degree(P0.05).Conclusion Therosclerosis of neck artery is closely related to coronary heart disease.Color Doppler ultrasound of neck artery may be used to predict coronary artery lesion degree of atherosclerosis. 　　【Key words】 　　Coronary heart disease; Atherosclerosis of neck artery; Coronary angiography; Color Doppler ultrasonography 　　 　　目前冠心病的诊断中,选择性冠脉造影术作为其“金标准”,具有创伤性、价格高、术后患者行动受制约等不利因素,影响此方法的普及。考虑到动脉粥样硬化广泛累及全身动脉系统,主要是大、中型动脉,特别是中型动脉,如冠状动脉和颈动脉,表现为斑块沉积和管腔狭窄[1],故颈动脉粥样硬化和冠状动脉粥样硬化有着密切的联系,它们都属于肌性动脉粥样硬化的部分,有着共同的病理基础和危险因素。因此,应用颈动脉超声检查来预测冠心病越来越受到关注。本研究拟通过对不同程度冠心病颈动脉内中膜厚度的测定,探讨此检查对冠心病诊断的预测价值。 　　 　　1 资料与方法 　　 　　1.1 对象 2008年1月至2009年3月疑似冠心病的住院患