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.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 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：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 1 1 资料与方法 2 2 结果 4 3 讨论 4 文2：冠心病患者颈动脉粥样硬化与冠状动脉粥样硬化的关系研究 6 观察组60 7 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 10 正文 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 文1：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 【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 numbe of plaque in carotid artery and endotheliumdependent dilation were measured by highfrequency ultrasound in patients with coronary artery disease and control reults were analyzed and compared. Results: There were significant differences in carotid artery IMT value,Crouse scores and numbe 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 was no difference between onevessel stenosis and multivessel stenosis seitivity and specificity of predicting the coronary artery atherocslerosis by the carotid plaque were 83% and 75%.Conclusion: Carotid artery atherosclerosic lesio 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、影响多处血管床的系统性疾病。利用超声影像定量测量技术[1]，直接对动脉血管壁病变进行评估，适用于动脉粥样硬化疾病的所有阶段。颈动脉和肱动脉表浅易被体表超声检测，是超声检测动脉病变最常采用的部位。本文旨在以体表动脉为窗口，探讨颈动脉粥样硬化及肱动脉内皮舒张功能与冠状动脉病变之间的关系。 1 资料与方法 一般资料 选取住院行冠状动脉造影检查的患者64例，男46例，女20例；年龄48～73岁；冠心病诊断标准为美国CASS:冠状动脉左主干狭窄≥50%和/或前降支、回旋支或右冠状动脉任一支狭窄≥70%，无狭窄或未达上述标准者为阴性。按病变血管支数分为单支血管病变组和多支血管病变组。 颈动脉彩色多普勒超声检查 所有研究对象在冠脉造影前或后1周接受超声检查，采用HP SONOS 5500及SSD5500SV彩色多普勒超声诊断仪，探头频率5～10MHz，均有专人操作。患者取仰卧位，颈部伸展，头部偏向检查对侧，探头置于胸锁乳突肌前缘或后缘，从锁骨上窝颈动脉起始处沿血管走行纵向扫查，依次观察颈总动脉、颈内动脉及颈膨大处，探头转动90°,自下而上横向扫查。二维图像观察血管走向、管壁、管径、内中膜厚度及有无斑块形成;用彩色多普勒超声显示血管内血流状态及血流充盈情况，在颈总动脉分叉处近心端1～2cm后壁测量内中膜厚度，两侧取平均值，管壁平整光滑IMT＜为正常，≤IMT＜为内膜增厚，局部隆