外周血管动脉粥样硬化对年轻冠心病患者的预测意义

目的探讨外周血管颈动脉、股动脉粥样硬化对年轻冠状动脉性心脏病（冠心病）的预测作用。方法根据冠状动脉造影结果将58例≤40岁的患者分为冠心病组（37例）和非冠心病组（21例），采用高分辨彩色多普勒超声同时检查颈动脉、股动脉，分别测量颈动脉内膜-中层厚度（carotid intima media thickness，CIMT）、股动脉内膜-中层厚度（femoral intima media thickness．FIMT），以内膜-中层厚度（intima media thickness，IMT）≥1．2mm为粥样硬化斑块。比较两组的CIMT、FIMT及斑块检出率．计算斑块对年轻冠心病的预测值。结果冠心病组CIMT、FIMT高于非冠心病组[（1．36±0．51）mm比（0．84±0．38）mm，P〈0．05：（1．48±0．84）mm比（0.74±0．26）mm．P〈0．05]．冠心病组颈动脉、股动脉粥样硬化斑块形成检m牢均明显高于非冠心病组．差异有统计意义i62ck（23／37）比9．5％（2／21）．P〈0．05；57％（21／37）比14％（3／21），P〈0．05]。颈动脉、股动脉粥样硬化斑块预测年轻冠心病的敏感性分别为62％、57％，特异性为90％、86％，阳性预测值分别为92％、88％，阴性预测值为58％、53％：颈动脉、股动脉联合检测未见明显提高预测值。结论外周血管颈动脉、股动脉粥样硬化与年轻冠心病相关，颈动脉、股动脉粥样硬化斑块对年轻冠心病患者均有预测作用，其特异性、阳性预测值均较高．

Prediction of coronary heart disease in young patients with peripheral artery atherosclerosis

Objectives To observe the predictive effects of carotid and femoral artery atheroselerosis in young patients of coronary heart disease（CHD）. Methods Coronary angiography measurement was performed in 58 patients who aged （36.8±3.1） years. They were divided into 2 groups： CHD group （n=37, at least 1 coronary artery stenosis ≥50%） and non-CHD group （n=21）. The carotid intima media thickness （CIMT） and femoral intima media thickness （FIMT） and atherosclerosis plaques [intima media thickness （IMT） ≥ 1.2 mm] were measured by high resolution uhrasound. The CIMT, FIMT and detection rate of atherosclerosis plaques were compared between the 2 groups and the predictive value was calculated. Results CIMT and FIMT in CHD group were significantly higher than those in non-CHI） group I（1.36＋0.51） mm vs. （0.84±0.38） mm, P〈0.05; （1.48±0.84） mm vs. （0.74±0.26） mm, P〈0.05 }. The detection rate of plaques in CHD group was significantly higher than those in non-CHD group [62% （23/37） vs.9.5% （2/21）, P〈0.05; 57% （21/37） vs.14% （3/21）, P〈0.05]. The sensitivity of carotid and femoral atherosclerosis plaques in young CHD patients was 62% and 57%. The specificity was 90% and 86%. The positive predictive value of carotid and femoral atherosclerosis plaques in young CHD patients was 92% and 88%. The negative predictive value was 58% and 53%. The predictive value of combinant measurement of carotid and femoral atherosclernsis plaques was not improved. Conclusions Carotid and femoral artery atherosclerosis are associated with young CHD. There is forecast function of the carotid and femoral atherosclerosis plaques in young CHD patients with high specificity and positive predictive value.