外周动脉粥样硬化预测非心肌梗死冠心病多支病变的价值

目的探讨外周动脉粥样硬化与冠状动脉粥样硬化的关系。方法对60例可疑非心肌梗死患者行冠状动脉造影，明确诊断为冠心病43例，无冠状动脉病变17例。同时超声检查颈、股动脉内膜-中层厚度（IMT）及斑块，并进行统计学分析。结果冠状动脉造影阳性者颈、股动脉的IMT和斑块发生率高于冠状动脉造影阴性者（P〈0．05），其粥样硬化的程度与冠心病的发生呈正相关。对左、右颈动脉和左、右股动脉的IMT与冠状动脉病变支数进行秩和检验，相关系数分别为0．466、0．312、0．273、0．378；颈、股动脉斑块与冠状动脉病变支数相关系数分别为0．823、0．738。颈、股动脉斑块诊断冠心病的灵敏度、特异度分别为60．47％和76．47％以及53．49％、70．59％。结论外周动脉IMT预测冠状动脉粥样硬化的灵敏度较高；但是预测冠状动脉病变支数的灵敏度较低；外周动脉斑块预测血管病变支数的灵敏度较高，对非心肌梗死冠心病多支病变有一定的诊断价值。

Predictive value of peripheral atherosclerosis for multiple vessels of non - acute myocardial infarction coronary heart disease

Objective To investigate the relationship between the peripheral atherosclerosis and the coronary atherosclerosis. Method Sixty suffered coronary arteriongraphy who were suspected non-myocardial infarction(AMI), among them coronary heart diseases were 43 cases, normal were 17 cases. Giving ultrasound check on carotid, femoral artery to measure the plaque, periphery artery intima-media thickness(IMT). Giving statistics analysis not only to the carotid, femoral artery IMT and revised Genisini grade of CAG. But to the IMT and plaque with the number of pathological coronary artery. Results The incidence of atherosclerosis plaque and carotid, femoral artery IMT in positive coronary angiography group were higher than those of normal group (P<0.05 ). The carotid, femoral artery IMT were positive correlation with revised Genisini grade. Carrying rank analysis on IMT and plaque with the number of pathological coronary artery, the coefficient correlation of the left, right carotid artery, left, right femoral artery IMT to the coronary artery pathological number were 0.466, 0.312, 0.273, 0.378 respectively. The sensitivity and specialization of carotid atherosclerosis plaque and femoral atherosclerosis plaque to diagnose the multiple vessels coronary heart disease were 60.47% and 76.47%, 53.49% and 70.59%. Conclusions The peripheral IMT have higher sensitiveness in predicting the pathological change of coronary artery but low sensitiveness in predicting the number of pathological coronary artery. The plaque of peripheral atherosclerosis have higher sensitiveness in predicting the number of pathological coronary artery.