原发性高血压患者颈动脉内膜中层厚度及斑块特征与冠心病的关系

目的探讨原发性高血压患者颈动脉内膜中层厚度（IMT）以及粥样斑块特征与冠状动脉粥样硬化性心脏病（冠心痛）的关系。方法将原发性高血压患者73例分为单纯高血压痛组（A组，20例）、合并冠心痛心肌缺血组（B组，38例）及合并冠心痛，心肌梗死组（C组，15例）。各组行颈动脉超声检查测量IMT井观察粥样斑块特征，计算斑块积分及斑块检出率，并进行比较。结果（1）IMT、斑块积分，C组明显高于A组和B组并有统计学意义（P〈0．01、P〈0．05），B组高于A组，也有统计学意义（P〈0．05）；（2）斑块检出率B、C组均高于A组有统计学意义（P〈0．05），B组、C组间无统计学意义（P〉0．05）；（3）C组软斑和渍疡斑检出率明显高于A组和B组且有统计学意义（P〈0．01、P〈0．05）。结论原发性高血压患者颈动脉的IMT及斑块特征与冠状动脉粥样硬化间存在着密切关系，超声检测原发性高血压患者的颈动脉IMT及斑块特征，既可以判断动脉粥样硬化程度，也在一定程度上反映冠状动脉的粥样硬化并与临床表现相关。

Association between intima-media thickness, plaque characterstics of the carotid artery and coronary artery disease in essential hypertensive patients

Objective To study the association between intima-media thickness(IMT),plaque characteristics of the carotid artery and coronary artery disease(CAD)in essential hypertension(EH) patients.Methods According to the result of coronary angiography,73 cases with EH were divided into simple EH(group A,20 cases),EH with heart muscle ischemia(group B,38 cases)and EH with myocardial infarction(group C,15 cases).The IMT,atherosclemtic plaques,scoring of atherosclerosis and the percentage of detection of arterial plaque were tested by carotid ultrasound.Results(1)IMT,scoring of atherosclerosis were obviously higher in group C than tthose in group A(P<0.01) and group B(P<0.05),also those in group B were higher than those in group A(P<0.05).(2)The percentage of detection of arterial plaque was significantly higher in group B and in group C than those in group A(P<0.05),there was no significantly difference between group B and group C(P>0.05).(3)The percentage of detection of soft and ulcerated plaques in group C was significantly higher than that in group A(P<0.01)and in group B(P<0.05).Conclusion IMT and plaque characteristics of the carotid artery measured by ultrasound in EH patients are useful indexes in prediction of coronary atherosclerosis,which can be used to evaluate CAD and its severity.