颈总动脉超声检查对预测冠心病的价值

目的 探讨颈总动脉超声检查预诊冠心病的价值，寻找一个较理想的早期预测动脉粥样硬化的指标。方法 用超声观察临床确诊的冠心病患者的双侧颈总动脉(CCA)及球部，并与部分冠脉造影对照。观察动脉内径、内-中膜厚度(IMT)、有无斑块及数量、是否钙化、彩色血流、血流速度、搏动指数、阻力指数(RI)，计算颈总动脉内一中膜横切面面积(IMCSA)。结果 本研究显示，动脉粥样硬化的表现多为动脉内径增大、IMT增厚、IMCSA增大、血流速度(舒张期和平均血流速度)减慢、PI和RI增加。本研究还显示，斑块形成以心绞痛组发生率最高，高血压组和心肌梗死组次之，以软性斑快为主，多在双侧CCA及分叉处。结论颈总动脉尤其分叉处的IMT增加或内-中膜精糙，回声增强，是动脉粥样硬化的早期表现，对预测冠心病具有一定的应用价值。

The value of carotid artery ultrasonic examination for predictiong coronary heart disease.

Objective To predict coronary atherosclerosis by carotid artery ultrasonic examination,and to find more ideal ultrasonic signs for the prediction of atherosclerosis.Method Using ultrasound to observe the carotid artery of the patients with clinical definite coronary heart disease,and compare with the coronary artery angiography (CAG) of partial patients.Observing items included the internal diameter of artery,internal and middle membrane thickness(IMT),amounts of plaque and calcification,velocity of blood stream,pulsation index(PI),and resistant index(RI) of left and right common carotid arteries(CCA).Calculated the cross-sectional area of the internal and middle membrane of the common carotid artery(IMCSA).Results It showed that the internal diameter of CCA augmented,IMT became thicker,IMCSA became larger,the velocity of blood stream became slower,PI and RI increased.This results also showed that the rate of plaque formation was the highest in the group with angina pectoris and higher in the group with hypertension and myocardial infarction.Conclusions The increase of the IMT at the cross of common carotid arteries,the rough changes of the internal and middle membrane,and the strong resonance are the early manifestations of atherosclerosis.