颈动脉粥样硬化对冠状动脉病变的预测分析

目的探讨颈动脉粥样硬化对冠状动脉病变的预测价值.方法对191例确诊为冠心病的患者及175例正常对照者行颈动脉超声检查,依冠状动脉造影结果分为对照组与冠心病单支病变组、双支病变组及多支病变组,比较各组间颈动脉内膜-中膜厚度及粥样硬化程度;并根据颈动脉粥样硬化的程度预测冠心病的发生、发展情况.结果对照组与冠心病各组在左侧内膜-中膜厚度、斑块发生率和狭窄率上存在差并(P＜0.05),而且冠状动脉病变支数越多颈动脉粥样硬化的程度也越重.以颈动脉斑块分级计分大于1、2和3分为标准预测冠心病的阳性预测值分别是68.5%、73.2%和74.6%.结论以上提示颈动脉粥样硬化是冠状动脉粥样硬化有价值的预测因素,通过颈动脉粥样硬化程度可预测冠状动脉病变的存在及其严重程度.

The Predictive Value of Carotid Atherosclerosis in Coronary Heart Disease

Aim To evaluate the predictive value of carotid atherosclerosis(CAS) in coronary heart disease(CHD). Methods Carotid ultrasound was performed in 191 CHD patients and 175 normal controls. These patients are divided into4 groups according to the results of angiography. Then intimia-media thickness(IMT) and the degree of carotid atherosclerosis were compared in 4 groups. According to the degree of carotid atherosclerosis, the presence of coronary heart disease will be predicted. Results We found that there were significant differences in intimia-media thickness and prevalence rate of atherosclerotic and narrowness rate of carotid artery between control group and the coronary heart disease groups (P<0.05). The more serious the coronary artery disease, the higher incidence rate of carotid artery atherosclerosis. The positive predictive value of carotid plaque score>1, 2, 3 was 68.5%, 73.2%, 74.6%. Conclusion The carotid atherosclerosis is regarded as a better predicative marker for coronary heart disease. Its extent may reflect directly the occurrence, severity and extent of coronary heart disease.