风心病患者瓣膜置换术前颈动脉超声检查的临床意义

目的探讨颈动脉粥样硬化与冠状动脉粥样硬化的相关性以及颈动脉内膜—中膜厚度(IMT)对风心病患者是否合并冠心病的预测价值。方法117例风心病患者根据冠状动脉造影结果分为冠心病组和对照组,用B超检测颈动脉病变情况。结果颈动脉IMT增厚和斑块检出率对冠心病预测的敏感性为81.82%(9/11),特异性为75.47%(80/106),阳性预测值为25.71%(9/35),阴性预测值为97.56%(80/82)。IMT异常与冠状动脉硬化程度积分呈显著正相关(r=0.55,P<0.01)。结论B超检测颈动脉粥样硬化对风心病患者是否合并冠心病具有预测价值。

Carotid artery ultrasononraphy on prediction of coronary atherosclerosis in patients with rheumatic heart disease scheduled for heart valve surgery

[Objective] To assess the value of carotid intima-mediat thickness (IMT) in prediction of significant coronary artery disease(CAD) in patients with rheumatic heart disease scheduled for heart valve surgery. [Methods] According to the results of coronary angiography,117 patients with rheumatic heart disease were divided into the group CAD and the group without CAD,and all patients in both groups received carotid artery B-mode ultrasound examination and coronary angiography before surgery. [Results] The sensitivities of IMT for predicting CAD were 81.82%,an the specificity was 75.47%,the positive predictive value was 25.71%,the negative predictive value was 97.56%.The correlation between the average value of IMT and the score of severity of coronary atherosclerosis is positive(r=0.55,P< 0.01). [Conclusion] There is close relationship between carotid artery atherosclerosis and coronary heart disease and carotid artery ultrasononraphy may predict the extent of coronary heart disease.