冠心病患者颅外颈动脉狭窄的发生率及危险因素

目的 观察可疑冠心病者颅外颈动脉狭窄（ECCAS）的发生率,评价致ECCAS的危险因素.方法 对106例患者行冠状动脉造影（CAG）后作颈动脉数字减影血管造影（DSA）;据CAG结果分正常及冠心病组,后者分为1、2、3支病变组;据DSA结果分为无ECCAS及有ECCAS组,后者分为轻、中、重度狭窄;危险因素与ECCAS的关系用单变量及多变量Logistic回归分析.结果 冠心病组ECCAS发生率（36.5%）明显高于对照组（6.3%）（P〈0.01）;冠状动脉病变程度与ECCAS程度显著正相关（rs=0.431,P〈0.01）;老龄（OR=1.183,P〈0.01）、高血压（OR=5.456,P〈0.01）、冠状动脉病变程度（OR=1.799,P〈0.05）是ECCAS的独立危险因素.结论 同时行CAG和颈动脉DSA显示,ECCAS多见于有高血压的老年严重冠心病患者.

Incidence and risk factors of extracranial carotid artery stenosis in patients with coronary artery disease

Objective To evaluate the incidence and risk factors of the extracranial carotid artery stenosis(ECCAS) in patients with coronary artery disease(CAD).Methods After coronary angiography(CAG),the carotid digital subtration angiography(DSA) was performed for all 106 patients immediately.All the patients were divided into contrast(without CAD) and CAD group.The CAD group was further divided into 1,2,3 branch stenosis vessel groups.The patients were divided into non-ECCAS and ECCAS groups,and the latter group was divided into normal,mild,moderate,severe stenosis.Univariate and multiple stepwise Logistic regression analysis were used to detect the association of CAD and ECCAS.Results The incidence of ECCAS in the CAD group((36.5)%) was higher than that of contrast group((6.3)%)(P<(0.01)).The extent of ECCAS was significantly associated with the severity of CAD(r_s=(0.431),P<(0.01)).By using multiple stepwise Logistic regression analysis,age(OR=(1.183),P<(0.01)),hypertension(OR=(5.456),P<(0.01)) and CAD severity(OR=(1.799),P<(0.05)) were the independent predictors of the incidence of ECCAS in the patients with CAD.Conclusion By undergoing both CAG and ECCAS,ECCAS was more common in older hypertension patients with severe CAD.