颈动脉超声检查联合血清超敏C反应蛋白水平检测在冠状动脉粥样硬化性心脏病诊断中的应用

目的探讨颈动脉超声检查联合血清超敏C反应蛋白(hs-CRP)检测在诊断冠状动脉粥样硬化性心脏病(CAHD)及判断冠状动脉狭窄程度中的应用价值。方法选取2010年10月至2014年1月在襄阳市中心医院住院治疗的CAHD患者280例(CAHD组),并选取同期健康体检者120例作为对照组。比较2组受试者的基线资料、临床特征及颈动脉超声检查结果,并分析CAHD患者冠状动脉狭窄的影响因素。结果 CAHD组患者的血清hs-CRP水平、吸烟比例及高脂血症发生率显著高于对照组,差异均有统计学意义(P<0.01);但2组受试者的血压、高血压患病率及CAHD家族史比较差异均无统计学意义(P>0.05)。CAHD组患者的动态动脉硬化指数(AASI)、内膜-中膜厚度(IMT)、斑块积分、发现斑块患者比例均显著高于对照组,差异有统计学意义(P<0.01)。冠状动脉轻度狭窄患者的血清hs-CRP水平、AASI、斑块积分均显著低于重度狭窄患者,差异有统计学意义(P<0.01,P<0.05);但冠状动脉轻度狭窄患者与冠状动脉重度狭窄患者的血压、IMT、发现斑块患者比例比较差异均无统计学意义(P>0.05)。结论颈动脉超声检查联合血清hs-CRP检测对于诊断CAHD及判断冠状动脉狭窄程度有重要意义。

Application of carotid ultrasonograph combined with serum level of high sensitivity C-reactive protein detection in the diagnosis of coronary atherosclerotic heart disease

Objective To explore the application of carotid uhrasonograph combined with serum level of high sensitivity C-reactive protein（hs-CRP） detection in the diagnosis of coronary atherosclerofic heart disease（CAHD） and judging the degree of coronary artery stenosis. Methods A total of 280 patients with CAHD （ CAHD group） who received treatment in Xiangyang Central Hospital from October 2010 to January 2014 were selected, and 120 healthy people were selected as control group in the same time. The basal data, clinical feature and carotid ultrasonograph of the subjects were compared between the two groups. The influencing factors for coronary artery stenosis in patients with CAHD were analyzed. Results The serum hs-CRP level, smoking ratio and hyperlipemia rate in CAHD group were significantly higher than those in control group （P 〈 0.01 ）. There was no significant difference in blood pressure, hypertension case rate and the family history of CAHD between the two groups （ P 〉 0.05 ）. The ambulatory arterial stiffness index （ AASI ） , intima-media thickness （IMT） , atherosclerotic plaque score and incidence rate in CAHD group were significantly higher than those in control group（P 〈0.01 ）. The serum hs-CRP level, AASI and atherosclerotic plaque score in patients with mild coronary artery stenosis were significantly lower than those in patients with severe coronary artery stenosis（ P 〈 0.01 ,P 〈 0.05 ）. There was no significant difference in blood pressure, IMT and atherosclerotic plaque incidence rate between the patients with mild coronary artery stenosis and the patients with severe coronary artery stenosis （ P 〉 0.05 ）. Conclusion Carotid ultrasonograph combined with serum hs-CRP detection has important significance for the diagnosis of CAHD and judging the degree of coronary artery stenosis.