颈动脉超声在冠心病诊断中的应用

目的：通过颈动脉超声和冠脉造影对粥样板块和颈动脉硬化级别对比，探讨颈动脉超声在冠心病诊断中的价值。方法对我院2010年1月~2013年12月间收治且经冠脉造影检查确诊为冠心病患者108例，另选30例健康体检者进行对比研究。收集冠脉造影检查数据，并对所有患者行颈动脉超声检查，观察粥样斑块数量、颈动脉硬化级别、IMT。结果两种检查粥样斑块数量、颈动脉硬化级别同组间对比差异不显著（P〉0.05）；不同组别同种检查粥样斑块数量、颈动脉硬化级别对比，均存在显著差异（P〈0.05）。以冠脉造影检查为金标准，颈动脉超声诊断IMT敏感度为86.58%，特异性为61.54%，诊断符合率为80.56%；颈动脉超声诊断粥样斑块敏感度为89.66%，特异性为57.14%，诊断符合率为83.33%。结论颈动脉超声可作为临床预测冠心病检查，缺乏数据依据，应加强两者间数据关系研究，以提高确诊率，相信随着研究的不断深入，定可作为无创、准确的冠心病检查方法。

Application of carotid artery ultrasonography for diagnosis of coronary heart disease

Objective To explore the value of carotid artery ultrasonography for diagnosis of coronary heart disease based on comparison of atheromatous plaque and carotid atherosclerosis degree detected by carotid artery ultrasonogra-phy and coronary angiography. Methods A total of 108 patients with coronary heart disease confirmed by coronary an-giography admitted and treated in our hospital from Jan 2010 to Dec 2013 were selected for study. Another 30 healthy controls receiving physical examination were selected for comparative study. Coronary angiography results were collect-ed. All the patients were given carotid artery ultrasonography to observe atheromatous plaque number, carotid atherosclerosis degree and IMT. Results There was no statistical difference with regard to atheromatous plaque number and carotid atherosclerosis degree between the two diagnostic approaches （P〉0.05）. There was significant difference with regard to atheromatous plaque number and carotid atherosclerosis degree between the two groups （P〈0.05）. With coronary angiography as gold standard, the sensitivity, specificity and diagnostic accordance rate of carotid artery ultra-sonography for IMT diagnosis was 86.58%, 61.54% and 80.56% respectively; The sensitivity, specificity and diagnostic accordance rate of carotid artery ultrasonography for diagnosis of atheromatous plaque was 89.66%, 57.14% and 83.33% respectively. Conclusion Carotid artery ultrasonography can be used for clinical prediction of coronary heart disease but lack of data evidence. It is suggested to strengthen researches on association between carotid artery ultra-sonography and coronary heart disease to improve diagnosis rate. With in-depth research, it will become a noninvasive and accurate diagnostic approach for coronary heart disease.