老年胸痛患者颈动脉硬化与冠状动脉病变程度的相关性

目的观察和分析老年胸痛患者颈动脉粥样硬化的特点及其与冠状动脉病变的关系。方法对199例胸痛患者行冠状动脉造影（CAG）和颈动脉超声检查，并根据CAG结果分为急性冠状动脉综合征（ACS）组（n=95）、稳定性心绞痛（SAP）组（n=63）和非冠心病组（n=41）。比较三组颈动脉内膜中层厚度（cIMT）和颈动脉斑块积分，分析ACS相关因素以及冠状动脉病变与颈动脉病变的关系。结果单因素非条件Logistic回归分析显示，老年ACS的发生与糖尿病、cIMT和颈动脉斑块相关（P〈0．05）；进一步的多因素非条件Logistic回归分析显示，cIMT和颈动脉斑块是老年ACS发病的独立危险因子（P〈0．05）。三组间cIMT、颈动脉斑块积分和冠状动脉造影结果比较差异有统计学意义（P〈0．05）。冠状动脉积分与颈动脉斑块积分呈显著正相关（r=0．75，P=0．000）。结论颈动脉粥样硬化程度与冠状动脉病变程度相关。对老年人群进行常规颈动脉超声检查可估测冠状动脉的病变程度，有利于冠心病的早期防治。

Relationship between carotid atherosclerosis and coronary atherosclerosis in elderly patients with chest pain

Objective To explore the characteristics of carotid atherosclerosis and investigate its relationship with coronary atherosclerosis in elderly patients with chest pain. Methods One hundred and ninety-nine patients with chest pain underwent coronary angiography (CAG) and carotid ultrasonography, and were classified into acute coronary syndrome (ACS) group (n=95), stable angina pectoris (SAP) group (n=63) and non-coronary artery disease group (n=41) according to CAG findings. The carotid intima media thickness (cIMT) and carotid artery plaques scores were compared among groups, ACS related factors were analysed, and the relationship between carotid atherosclerosis and coronary atherosclerosis was explored. Results Univariate Logistic regression analysis revealed that the occurrence of ACS in the elderly was related to diabetes mellitus, cIMT and carotid artery plaques scores (P<0.05). Non-condition multivariate Logistic regression analysis indicated that cIMT and carotid artery plaques scores had significant regression effects on ACS in the elderly (P<0.05). There were significant differences among the results of cIMT, carotid artery plaque scores and CAG (P<0.05). Carotid artery plaque scores were significantly related to coronary artery scores (r=0.75, P=0.000). Conclusion Carotid atherosclerosis is significantly related to coronary atherosclerosis. The severity of coronary atherosclerosis can be predicted by carotid ultrasonography.