冠心病患者冠状动脉斑块形态与颈动脉斑块的相关性研究

目的]研究冠心病患者不同类型冠状动脉斑块与颈动脉斑块的相关性.方法]收集经冠脉造影诊断为冠心病患者90例,根据斑块形态,冠心病患者分为三组,即Ⅰ型病变（表面光滑）组30例,Ⅱ型病变（表面不规则）组30例和Ⅲ型病变（长段不规则）组30例,另设冠脉造影正常的30例为对照组.采用高频超声探测各组双侧颈动脉内-中膜厚度（IMT）和软斑指数（PI）,硬斑PI及总斑PI.结果]冠心病组CCA-IMT、软斑PI、硬斑PI、总斑PI高于对照组 （P〈0.01）;冠心病Ⅱ型病变组软斑PI、总斑PI明显高于Ⅰ型、Ⅲ型病变组（P〈0.01）, CCA-IMT、硬斑PI高于Ⅰ、Ⅲ型病变组,但无统计学差异（P〉0.05）;Ⅰ型病变组与Ⅲ型病变组相比各指标无统计学差异（P〉0.05）.结论]颈动脉斑块（特别是软斑）的检出可以在一定程度上反应冠心病患者冠状动脉斑块的形态.

Relationship Between Carotid Atherosclerotic Plaque and Angiographic Morphology of Coronary Lesions in Patients with Coronary Heart Disease

Objective]To evaluate the relationship between angiographic morphology of coronary lesions and carotid plaque in patients with coronary heart disease. Methods]One hundred and twenty patients were enrolled in this study. All patients underwent coronary angiography. There were 90 patients with coronary heart disease （CHD） and 30 controls. The angiographic morphology of plaques was analyzed. According to the morphologic types of plaque, the patients with CHD were divided into type Ⅰ （smooth borders） group （ n = 30） and type Ⅱ （irregular lesions） group （ n =30） and type Ⅲ （long lesions） group （ n =30）. Intima-media thickness（IMT） and plaque indices（H） of carotid artery in all patients were assessed by high frequency ultrasound. Results]Compared with normal group, CCA IMT, soft and hard plaque indices, total plaque index in patients with coronary heart disease were significantly increased（ P 〈0.01）. CCA-IMT and hard plaque indi ces in type Ⅱ group were higher than that type Ⅰ group and type Ⅲ group, but there was no significant difference（ P〈0.05）. Soft plaque indices and total plaque index in type Ⅱ group were significantly higher than those in type Ⅰ group and type Ⅲ group（ P d0.01）. CCA-IMT, soft and hard plaque indices, total plaque index in type group were not different from those in type Ⅲ group （ P 〉0.05）. Conclusion]Anglographic morphology of coronary artery lesion in patients with coronary heart disease can be predicted by carotid atherosclerotic plaque （specially for soft plaque） assessed by ultrasonography.