老年冠心病患者颈动脉硬化的超声研究

目的 探讨老年冠心病患者颈动脉超声特征及血流动力学变化.方法 根据冠状动脉造影结果,将548例患者分为:冠心病组373例,对照组175例.再将冠心病组是否合并心肌梗死分为:心肌梗死组160例,非心肌梗死组213例.所有患者年龄均在60岁以上,全部行颈动脉超声检测.运用统计软件分析所检测的颈动脉声像图和血流动力学参数.结果 冠心病组的颈动脉内中膜厚度、斑块厚度、斑块积分分别为(0.96±0.24)mm,(1.90±0.36)mm,(2.2±0.7)分均高于对照组的颈动脉内中膜厚度(0.78±0.11)mm,斑块厚度(1.66±0.13)mm和斑块积分(1.9±0.4)分(t分别为14.81,27.89,27.83,P均为0.00);冠心病组有斑块者161例(43.2%)高于对照组有斑块者7例(4.0%),差异有统计学意义(χ~2=337.18,P=0.00);心肌梗死组有斑块者81.3%,高于非心肌梗死组的14.6%(χ~2=60.88,P=0.00);冠心病组的颈动脉峰值血流速度(77.0±11.9)cm/s和阻力指数0.77±0.06均较对照组的血流速度(65.2±3.1)cm/s和阻力指数0.67±0.08高(t分别为12.26,50.43,P均为0.00).结论 颈动脉超声不仅可作为评价老年冠心病患者的一个窗口,而且可以预测老年冠心病病程的严重程度.

Study of carotid atherosclerosis by sonography in elderly patients with coronary heart disease

Objective To discuss the uhrasonography and hemodynamic characteristics of carotid atherosclerosis in elderly patients with coronary heart disease (CHD).Methods The 548 people were divided into CHD group (n = 373) and control group (n = 175) by the coronary angiography.And the patients in CHD group were sorted into myocardial infarction (MI) group (n= 160) and non-MI group (n= 213).All patients were above 60 years of age, and underwent carotid artery ultrasound examination.The data of carotid sonography and hemodynamics were classified and analyzed using SPSS 10.0 software.Results The carotid intima-media thickness (IMT), plaque thickness and score were much more in CHD group than in control group (0.96±0.24) mm vs.(0.78±0.11) mm, (1.90±0.36) mm vs.(1.66±0.13)mm, (2.2±0.7) vs.(1.9±0.4), t= 14.81, 27.89 and 27.83, all P=0.00].A total of 161 (43.2%) patients had atherosclerotie plaques in CHD group, and there were 7 (4.0%) people with plaques in healthy control group(χ~2 =337.18, P =0.00).And there were 81.3% of patients with plaques in MI group, it was more than non-MI group, in which there were 12.9% of patients with plaques (χ~2 =60.88, P=0.00).The carotid peak systolic velocity (PSV) and resistance index (RI) were both higher in CHD group than in control group (77.0±11.9) cm/s vs.(65.2±3.1) cm/s and 0.77±0.06 vs.0.67±0.08, (t= 12.26 and 50.43, P=0.00)].Conclusions Carotid ultrasonography could evaluate not only CHD, but also CHD severity in the elderly.