颈动脉内-中膜厚度与冠状动脉病变严重程度相关性研究

目的探讨颈动脉内-中膜厚度(IMT)及动脉粥样硬化斑块与冠状动脉粥样硬化狭窄程度的相关性。方法对198例拟诊冠心病并行冠脉造影的患者为研究对象,根据管腔狭窄程度分为非冠心病组(50例)和冠心病组(148例);并将冠心病组分为单支病变组(48例)、双支病变组(56例)及多支病变组(44例)并进行Gensini积分。所有患者均行双侧颈动脉彩色多普勒超声检查,检测颈动脉IMT及斑块Crouse积分情况,并对冠状动脉Gensini积分行相关性分析。结果 CAD组多支病变、双支病变、单支病变亚组及对照组冠状动脉Gensini积分分别为45.06±7.27、30.83±4.50、24.83±4.94和13.75±1.74,颈动脉IMT分别为(2.13±0.32)mm、(1.68±0.14)mm、(1.12±0.13)mm和(0.93±0.17)mm,颈动脉粥样硬化斑块Crouse积分分别为2.85±1.21、1.62±0.14、1.03±0.09、0.29±0.08,组间差异有统计学意义(P<0.05)。冠心病组颈动脉IMT及粥样斑块Crouse积分与冠状动脉Gensini积分呈正相关。结论颈动脉IMT及粥样斑块与冠状动脉粥样硬化狭窄程度、范围有密切相关性。颈动脉超声检查可作为筛查CAD和评价抗动脉硬化治疗疗效的一种手段。

Research on the correlation between carotid intima - media thickness and extent of coronary atherosclerosis.

Objective To examine the relationship between carotid intimamedia thickness （IMT） and extent of coronary athereselerosis. Methods After diagnosed by coronary angiography （ CAG）, 198 patients were divided into coronary artery disease （CAD） group （ n = 148 ） and non - coronary heart disease （ n = 50）. Patients in CAD group were separated into 3 subgroups based on coronary artery pathological changes including single vessel （n = 48 ）, two vessel （n = 56 ） and multi -vessel （n = 44） coronary disease, and the severity of coronary artery was graded according to Gensini score system respectively. In all patients, carotid artery intima - media thickness （ CCA - IMT） was measured by color Doppler ultrasound. The severity of CCA - IMT was evaluated on the basis of Crouse grade system. Then, the relationship between CCA - IMT and CAD was analyzed. Results Gensini scores in single vessel, two vessel and multi - vessel CAD group and non - CAD group were 45.06 ± 7.27, 30.83 ± 4.50, 24.83 ± 4.94 and 13.75 ± 1.74,respectively. CCA - IMT was 2.13 ± 0.32mm, 1.68 ± 0.14mm, 1.12 ± 0.13ram and 0.93 ± 0.17ram, respectively. Crouse scores of plaque were 2.85 ± I. 21, 1.62 ± 0.14, 1.03 ± 0.09 and 0.29 ＋ 0.08, respectively. CCA - IMT and Crousc score of CAD group were obviously higher than those of non -CAD group （ P 〈 0.05 ）. In CAD group, CCA -IMT and Crouse score correlated positively with Gensini score of coronary artery （ P 〈 0.05 ）. Conclusion CCA - IMT and plaques have great value in predicting the severity of coronary atheroscleresis. Combining CCA - IMT with CCA plaques may be a premising means for screening CAD and evaluating the therapeutic effect of anti - atberoscleresis.