超声评价颈、股动脉内-中膜厚度与冠心病相关性研究

目的 探讨颈动脉（CA）、股动脉（FA）的内一中膜厚度（IMT）对冠心病（CAD）的诊断价值。方法 对189例连续冠脉造影（CAG）受检者术前利用高频超声进行CA、FA的IMT检查，并与CAG结果进行相关性研究。结果 CAD单支病变组、多支病变组CA、FA的IMT增厚以及斑块发生率均明显高于对照组（P〈0．01）；多支病变组CA、FA的IMT显著高于单支病变组，斑块发生率与单支病变组之间无显著性差异（P〉0．05），CA粥样硬化斑块对CAD诊断的敏感度、特异度及对CAD阳性预告值分别为72．3％、79．2％及89．5％；FA粥样硬化斑块对CAD诊断的敏感度、特异度及对CAD阳性预告值分别为83．2％、77．8％及90％；CA、FA两处均有粥样硬化斑块对诊断的敏感度、特异度及对CAD阳性预告值分别为84．1％、87．6％及93．1％。结论 CAD患者及具有其危险因素人群中，进行CA、FA超声检查，可成为研究CAD的间接指标和窗口。

The Study of Intima-media Thickness of Carotid,Femoral Artery and Endothelium-dependent Dilation in Patients with Coronary Heart Disease

Objective To investigate the diagnostic value of carotid,femoral artery ultrasonography and endothelium-dependent dilation for coronary atherosclerotic disease.Methods Carotid,femoral artery(CA,FA) ultrasonography and analysis of endothelium-dependent dilation were conducted in 189 consecutive patients who underwent examines of coronary anginography and the correlation between two examinations was analyzed. Results The IMT and plaque incidence of CA and FA with CAD patients with one or multiple diseased coronary artery branches were all greater than those of the control group(P<0.01). The IMT of patients with multiple diseased branches was higher than that with one,and there was no difference in plaque incidence(P>0.05). The sensitivity,specificity and predictive value to CAD of atherosclerotic plaque in CA were 83.2%,77.8%and 90% respectively;and in both CA and FA were 84.1%,87.6% and 93.1% respectively. EDD of brachial artery induced by reactive hyperemia of CAD patients with one and several diseased branches were more less than the control group(P>0.05).Conclusions In patients with CAD and persons with CAD risk factors,examinated in carotid,femoral artery and the endothelial function using high-frequency ultrasound,these methods can provide evidences of CAD in earlier period,also can monitor patient's condition and predict prognosis,can be a surrogate and window for studying the occurrence,progression of coronary artery atherosclerosis.