颈动脉粥样硬化伴多种危险因素的患者与冠心病的关系

目的:利用无创高分辨率二维超声比较冠心病(CAD)患者与非CAD患者颈动脉内中膜厚度(IMT)及粥样斑块的发生情况,探讨颈动脉粥样硬化伴多种危险因素的患者与CAD的关系.方法:经过冠状动脉造影的137例患者根据血管病变分成分为4组:冠状动脉造影正常组(n=31)、单支病变(n=36)、双支病变(n=33)、三支病变(n=37),在冠状动脉造影前、后1周内进行颈动脉超声检查,同时测定其生化、血脂水平,测量患者的收缩压、舒张压;计算体重指数,并记录其吸烟史、高血压史、糖尿病史.结果:冠状动脉病变组患者的颈动脉壁内-中膜厚度及粥样斑块的发生明显高于冠状动脉造影正常组,且有统计学意义;随着颈动脉壁内-中膜厚度的增加,CAD的发生明显增加.结论:在颈动脉粥样硬化中,颈动脉内中膜厚度与CAD关系最为紧密,可利用颈动脉超声检查来筛查出伴有心血管多种危险因素CAD的高危患者.

The Relationship between Carotid Atherosclerosis with Several Risk factors and Coronary Artery Disease

Objective: To observe the relationship of carotid atherosclerosis with multiple risk factors and coronary artery disease(CAD), from comparing carotid intima-media thickness and incidence of carotid artery plaque between patients without CAD and patients with CAD by using non invasive high resolution 2D-ultrasonography. Methods: After coronary angiography, 137 inpatients divided into 4 groups according to the number of injured vessels; normal group (n=31), single vessel disease (n=36), double vessel disease (n=33), triple vessel disease (n=37). The patients' characteristics were recorded, which included history of smoking,hypertension and diabetes, meanwhile the blood pressure and body mass index(BMI) were measured. The chemical and blood lipoid were measured at the second day of admission. One week before and after coronary angiography, carotid artery ultrasonography was conducted . Results: In coronary heart disease, the thicker intima-media thickness and higher incidence rate of plaque in coronary heart disease . The more thicker of carotid intima-media thickness, the more coronary heart disease. Conclusion: There was more relationship between intima-media thickness and carotid artery plaque in coronary heart disease. Carotid ultrasonography could predict the incidence of coronary artery disease for patients with multiple risk factors.