颈动脉粥样斑块及内膜厚度与冠状动脉病变的相关性研究

目的探讨颈动脉内膜厚度(IMT)以及粥样斑块发生率情况与冠状动脉疾病的关系。方法采用冠状动脉造影术筛选冠心病与非冠心病对照组,对181例经选择性冠状动脉造影检查的患者行颈动脉超声检查,测量IMT以及观察粥样斑块发生率情况。结果对照组及冠心病组IMT为(0.72±0.08)mm及(0.97±0.27)mm,斑块发生率分别为9.26%(5/54)及61.4%(78/127),两组比较具有显著性差异,P<0.001,以IMT≥0.85mm及/或出现粥样斑块来预测冠心病,敏感性68.5%,特异性79.6%,阳性预测值88.7%。结论颈动脉与冠状动脉粥样硬化间存在着密切关系,通过颈动脉超声检查可预诊冠心病的存在。     

颈动脉粥样斑块及内中膜厚度与冠心病的关系

目的 :探讨颈动脉内中膜厚度 (IMT)以及粥样斑块发生率情况与冠心病的关系。方法 :采用冠状动脉造影术筛选冠心病及非冠心病组 ,对 114例经选择性冠状动脉造影检查的患者行颈动脉超声检查 ,测量IMT以及观察粥样斑块发生率情况。结果 :对照组及冠心病组IMT为 0 6 7± 0 10mm及 0 85±0 2 6mm ,斑块发生率为 10 % (4 /4 0 )及 6 3.5 % (4 7/74) ,组间相比均具有显著性差异 ,P <0 0 0 1,以IMT≥ 0 85mm及 /或出现粥样斑块来预测冠心病 ,特异性 85 % ,敏感性 71.6 % ,阳性预测率 89.8%。结论 :颈动脉与冠状动脉粥样硬化间存在着密切关系 ,通过颈动脉超声检查可预诊冠心病的存在     

颈动脉粥样硬化与冠心病的关系

目的:探讨颈动脉粥样硬化与冠心病的关系。方法:根据冠状动脉造影结果将101例病人分为冠心病组及对照组,再根据受累血管数将冠心病组又分为一支病变组、二支病变组及三支病变组。应用高频超声测定所有病例双侧颈总动脉的内-中膜厚度(IMT)、颈总动脉内径,进行分析。结果:冠心病组的左颈动脉的平均IMT为(0.91±0.13)mm,平均内中膜横切面面积(IMCSA)为(22.13±3.21)mm2,而对照组的左颈动脉的平均IMT为(0.84±0.06)mm,平均IMCSA为(18.06±1.15)mm2,两组的差异有统计学意义(P<0.01);冠心病组斑块发生率为63.7%,对照组的斑块发生率为34.6%,差异有统计学意义(P<0.01)。以左颈总动脉IMT0.845mm为界限预测冠心病的敏感性为68.8%,特异性为67.3%;以左颈总动脉IMCSA19mm2为界限预测冠心病的敏感性为87.5%,特异性为84.6%。结论:颈动脉粥样硬化可作为冠心病的预测因子,为临床诊断提供依据。     

颈动脉粥样斑块及内中膜厚度与冠心病的关系

目的:探讨颈动脉内中膜厚度(IMT)以及粥样斑块发生率情况与冠心病的关系.方法:采用冠状动脉造影术筛选冠心病及非冠心病组,对114例经选择性冠状动脉造影检查的患者行颈动脉超声检查,测量IMT以及观察粥样斑块发生率情况.结果:对照组及冠心病组IMT为0.67±0.10 mm及 0.85±0.26 mm,斑块发生率为10%(4/40)及63.5%(47/74),组间相比均具有显著性差异,P<0.001,以IMT≥0.85mm及/或出现粥样斑块来预测冠心病,特异性85%,敏感性71.6%,阳性预测率89.8%.结论:颈动脉与冠状动脉粥样硬化间存在着密切关系,通过颈动脉超声检查可预诊冠心病的存在.     

颈动脉粥样硬化与冠心病的关系

目的:探讨颈动脉粥样硬化与冠心病的关系. 方法:根据冠状动脉造影结果将101例病人分为冠心病组及对照组,再根据受累血管数将冠心病组又分为一支病变组、二支病变组及三支病变组.应用高频超声测定所有病例双侧颈总动脉的内-中膜厚度(IMT)、颈总动脉内径,进行分析. 结果:冠心病组的左颈动脉的平均IMT为(0.91±0.13)mm,平均内中膜横切面面积(IMCSA)为(22.13±3.21)mm2,而对照组的左颈动脉的平均IMT为(0.84±0.06)mm,平均IMCSA为(18.06±1.15)mm2,两组的差异有统计学意义(P＜0.01);冠心病组斑块发生率为63.7%,对照组的斑块发生率为34.6%,差异有统计学意义(P＜0.01).以左颈总动脉IMT0.845 mm为界限预测冠心病的敏感性为68.8%,特异性为67.3%;以左颈总动脉IMCSA19 mm2为界限预测冠心病的敏感性为87.5%,特异性为84.6%. 结论:颈动脉粥样硬化可作为冠心病的预测因子,为临床诊断提供依据.     

老年女性冠心病患者颈动脉粥样硬化和血管内皮依赖性舒张功能的探讨

目的　观察老年女性冠心病患者颈动脉内中膜厚度 (IMT)、粥样斑块发生率及肱动脉内皮依赖性舒张功能的情况。方法　用高分辨超声技术对 89例老年女性行肱动脉血流介导的舒张功能 (FMD)、IMT及颈动脉粥样斑块的检测。结果　老年女性冠心病组FMD较对照组明显减弱 ,分别为 (3.5± 3.1) %及 (7.6± 3.5 ) % ,P <0 .0 0 1,老年女性冠心病组及对照组IMT分别为 (0 .88± 0 .2 0 )mm及 (0 .6 5± 0 .2 3)mm ,颈动脉粥样斑块发生率分别为 6 2 .2 %及11.4 % ,两组比较差异具有显著性意义 ,P <0 .0 0 1。结论　老年女性冠心病患者存在着严重的血管内皮依赖性舒张功能障碍以及颈动脉粥样硬化 ,颈动脉B超及肱动脉血流介导的舒张功能对老年女性冠心病患者有一定的预测价值。     

颈动脉粥样硬化与冠心病关系的研究

目的研究颈动脉粥样硬化与冠心病的关系。方法对301例冠状动脉造影的患者作双侧颈动脉超声检查，根据冠脉造影结果分为正常组及冠心病组，冠心病组根据冠状动脉病变支数再分为一支病变组，二支病变组，三支病变组3个亚组。测量颈总动脉后壁内中膜厚度(IMT)，斑块厚度，计算斑块积分及粥样斑块发生率。结果(1)冠心病组IMT，斑决积分及斑块发生率明显高于正常对照组(P＜0.01)。(2)随冠脉病变支数增加，斑块积分及IMT增加，亚组比较有显著性差异(P＜0.01)。(3)以IMT＞0.85mm和(或)出现粥样斑块预测冠心病，特异性75.3％，敏感性84.6％，阳性预测率88.4％。结论通过颈动脉超声检查可为冠心痛的诊断提供依据。     

颈动脉内膜-中层厚度及斑块与冠心病的关系

目的:探讨颈动脉内膜 中层厚度(IMT)及斑块在判断冠心病(CHD)及其严重程度方面的价值。方法:对104例可疑或确诊的CHD患者,用高分辨率超声心动图测量双侧颈总动脉远端的 IMT、斑块与选择性冠状动脉造影结果进行对比研究,比较CHD组(62例)和非 CHD组(42 例)及 CHD各亚组间颈总动脉 IMT及斑块发生率,冠状动脉受累支数及程度与 IMT、斑块的关系。结果:①CHD患者的平均颈总动脉 IMT及斑块的发生率均显著高于非CHD组患者(P<0.01),多支病变者高于单支病变者(P<0.05)。②平均颈总动脉 IMT与CHD患者冠状动脉狭窄程度无显著相关( r=0.164,P>0.05),CHD患者中有斑块者的冠状动脉狭窄程度显著重于无斑块者(P<0.05);斑块积分与冠状动脉狭窄程度呈显著正相关( r=0.448, P<0.01)。③斑块的发生判断CHD的敏感性为40.32%,特异性为97.67%。结论:超声测量颈总动脉 IMT、斑块可间接判断 CHD的有无及其病变范围和严重程度。     

颈动脉粥样硬化与冠心病关系的研究

目的:研究颈动脉粥样硬化与冠心病的关系。方法:对301例冠状动脉造影的患者作双侧颈动脉超声检查,根据冠脉造影结果分为正常组及冠心病组,冠心病组根据冠状动脉病变支数再分为一支病变组,二支病变组,三支病变组3个亚组。测量颈总动脉后壁内中膜厚度(IMT),斑块厚度,计算斑块积分及粥样斑块发生率。结果:(1)冠心病组IMT,斑块积分及斑块发生率明显高于正常对照组(P<0.01)。(2)随冠脉病变支数增加,斑块积分及IMT增加,亚组比较有显著性差异(P<0.01)。(3)以IMT>0.85mm和(或)出现粥样斑块预测冠心病,特异性75.3％,敏感性84.6％,阳性预测率88.4％。结论:通过颈动脉超声检查可为冠心病的诊断提供依据。     

颈动脉多普勒超声与心绞痛患者冠状动脉病变的关系

目的采用彩色多普勒超声仪分析心绞痛患者颈动脉病变,探讨其在冠状动脉病变中的临床诊断价值。方法选择因心绞痛行冠状动脉造影的住院患者328例,根据冠状动脉造影结果分为4组:对照组(80例)、单支病变组(102例)、2支病变组(62例)和多支病变组(84例)。用彩色多普勒超声仪测量颈总动脉内膜中层厚度(intimamediathickness,IMT)及颈动脉分叉处IMT,记录颈动脉斑块的位置、数量。结果与对照组比较,2支病变组分叉处IMT和斑块积分明显增高,多支病变组颈总动脉IMT、分叉处IMT和斑块积分明显增高,差异有统计学意义(P0.05,P0.01)。与对照组比较,多支病变组颈总动脉IMT增厚比例明显增高,差异有统计学意义(P0.05);与单支病变组比较,多支病变组颈总动脉IMT增厚比例明显增高,差异有统计学意义(P0.05)。糖尿病是冠状动脉病变的主要危险因素(OR=2.8,95% CI:1.18～6.63)。结论颈动脉粥样硬化与冠状动脉病变有相关性,采用彩色多普勒超声分析颈动脉病变情况,对冠心病患者具有较好的筛查及预测价值。     

Interosseous artery as an access artery in case of late radial artery occlusion

We report a new technique of arterial access through the ipsilateral interosseous artery in a case of late radial artery occlusion (RAO). RAO, although not frequent, is a limiting iatrogenic complication after transradial intervention (TRI) and precludes repeat use of the same radial artery for future procedures. Our technique involves obtaining access to the ipsilateral radial artery (RA) in the distal postocclusion segment and use of collateral channel between this segment and the interosseous artery (IOA) for advancing a guidewire and sheath in the IOA lumen and in brachial artery thereafter. © 2017 Wiley Periodicals, Inc.     

Coronary artery to pulmonary artery fistulas.

Twelve patients with a total of 14 coronary artery to pulmonary artery fistulas were discovered at the time of diagnostic coronary angiography. Six patients had severe coronary artery disease, five patients had normal coronary arteriography, one patient had insignificant coronary artery disease, and one patient had rheumatic heart disease. Only two patients had characteristic continuous murmurs; one patient had a normal coronary angiogram, and the second patient had severe coronary artery disease. Ten fistulas originated from the left anterior descending artery, three from the right coronary artery, and one from the left circumflex artery. The fistulas were either composed of one large (five fistulas) or one or more small channels (seven fistulas) or poorly defined plexiform channels (two fistulas). Hydrogen studies performed in two patients were negative and dye dilution curves performed in all patients were normal. In only four out of the six patients with severe coronary artery disease, the fistulas originated from a diseased vessel and in each case the origin was proximal to the narrowing. The pathogenesis and functional role of these fistulas is largely unknown.     

Single right coronary artery with absence of the left main coronary artery,left anterior descending artery,and circumflex artery

Single coronary artery is an extremely rare congenital coronary anomaly in which the entire coronary arterial system arises from a solitary ostium. The Lipton's classification is used for single coronary artery anomalies. Herein, we present a 72‐year‐old woman with single coronary artery anomaly admitted with atypical chest pain. Coronary angiography and multidetector computed tomography coronary angiography findings were shared.     

桡动脉在冠状动脉旁路移植术中的应用(附18例报告)

目的　总结以桡动脉为旁路移植物的冠状动脉旁路移植术中的桡动脉制备方法和早期结果。方法　对 18例患者以桡动脉行冠状动脉旁路移植术。术前以改良 Allen试验评判桡、尺动脉通畅性。术中上肢外展 90°,肘窝以远 3cm至腕关节线内 2 cm做弧形皮肤切口 ,将桡动脉连同伴行静脉和脂肪组织一并游离。分支以钛夹夹闭。严格避免夹镊桡动脉本身。离断后腔内注入肝素化罂粟碱 ,并置于该液中备用。共制取桡动脉 18根。远端吻合至后降支及钝缘支 ,近端均吻合至主动脉。术后常规应用钙阻滞剂 12个月。结果　术后患者心绞痛消失 ,心功能显著改善。无手臂缺血发生 ,未见围术期心肌梗死。结论　应用桡动脉行冠状动脉旁路移植术简便、安全 ,手术效果好。严格的“免触”制备技术和术后应用钙通道阻滞剂是保证桡动脉良好功能的关键     

CT evaluation of renal artery embolism with ectopic artery

We present an 80-year-old woman, with a history of well-controlled hypertension and atrial fibrillation, who suffered from back pain and elevated blood pressure for 2 weeks prior to admission. At physical examination, a low-pitched systolic heart murmur was heard in the tricuspid area and there was mild tenderness in the left lower quadrant. Laboratory studies revealed an elevated hematocrit, lactate dehydrogenase, and liver aminotransferase. Macroscopic hematuria was present in urine and 20% eosinophils were detected with Hansel's stain method. Assuming a possible vascular embolic episode, angiography of the renal arteries was performed, which revealed an obstructive pattern in the presence of a left duplicate system.