颈动脉、低密度脂蛋白预测冠状动脉粥样硬化性心脏病探讨

目的探讨颈动脉、低密度脂蛋白诊断作为预测冠状动脉粥样硬化性心脏病（简称冠心病）诊断指标的临床可行性。方法我院收治的经冠脉造影确诊126例冠心病患者,做双侧颈动脉彩色多普勒超声（简称彩超）检查及血浆脂质水平测定,用Cmuse法计算颈动脉斑块积分,研究颈动脉斑块积分与低密度脂蛋白胆固醇（LDL-C）指标在预测冠心病的可行性。结果根据颈动脉彩超检查结果显示88.1%的冠心病患者颈动脉处增厚形成斑块,斑块的发生率达85.7%。以Crouse积分法判断将动脉是否有斑块发生为前提做LDL-C检查,有斑块的患者LDL-C指标高于没有斑块的患者（P〈0.05）。结论颈动脉彩超检测结合LDL-C检测对冠心病的预测性诊断具有一定的指导性,但作为预测性诊断的标准仍需要大量的临床试验和科学的理论基础。

Prediction of coronary atherosclerotic heart disease based on carotid artery and LDL

Objective To investigate the clinical feasibility of using carotid artery and low-density lipoprotein as the diagnostic indicators for coronary atherosclerotic heart disease(CHD).Methods 126 cases of CHD confirmed with coronary angiography admitted in the authors′ hospital were given bilateral carotid color Doppler ultrasound(referred to as ultrasound) examination and plasma lipid levels measurement.The carotid plaque score was calculated with Cmuse method.The feasibility of using neck artery plaque score and low-density lipoprotein cholesterol(LDL-C) as prediction indicators for coronary heart disease was studied.Results Carotid color Doppler ultrasound examination results showed that 88.1% of coronary heart disease patients demonstrated carotid artery thickening and plaque formation,with a plaque occurrence rate of 85.7%.Plaque formation was determined with the artery Crouse score method and patients were then given LDL-C test.LDL-C was significantly higher in patients with plaque than in patients without plaque(P < 0.05).Conclusion Carotid ultrasonography detection combined with LDL-C test can provide guidance for the predictive diagnosis of coronary artery disease,but the criteria of prediction with both indicators still need to be based on a large number of clinical trials and scientific theoretical foundation.