冠状动脉病变与颅内动脉狭窄的相关性分析  

Association between coronary artery disease and intracranial stenosis by transcranial Doppler ultrasonography

作　　者：宋丽清[1] 李小玉[1] 楚卡琳[1] 张萍[1] 

机构地区：[1]北京积水潭医院干部保健科,北京100035

出　　处：《临床荟萃》2007年第15期1071-1073,共3页Clinical Focus

摘　　要：目的 分析冠心病患者冠状动脉病变程度与颅内动脉狭窄患病率的关系。方法 收集我院干部科因怀疑冠心病或原有冠心痛需要介入治疗而作经皮冠状动脉造影（CAG）的病例，利用经颅多普勒超声（TCD）探查颅内动脉狭窄情况。所有病例根据CAG受累血管数分为4组：正常组、1、2、3支病变组。结果 82例患者CAG冠状动脉正常组17例，1、2、3支病变组分别为25、22、18例。4组患者颅内动脉狭窄患病率分别为23．5％、28.0％、59．1％、66．7%；趋势卡方检验结果，P〈0．01，上升趋势有统计学意义。多支冠状动脉病变组颅内动脉狭窄率（62．5％）高于单支病变组（28%），P〈0．05。多因素分析结果，冠状动脉多支病变是冠心病患者发生颅内动脉狭窄的独立危险因素，P=0．01（OR4．542，95％CI为1．434～14．393；P〈0．05）。结论 随冠状动脉病变部位的增加，颅内动脉狭窄率有增加趋势。Objective To investigate the prevalence of intracranial stenosis in the patients with coronary artery disease（CAD）. Methods Transcranial Doppler ultrasonography （TCD） was performed in 82 patients who were checked with coronary angiography （CAG）. Each patient was classified into one of the following groups according to the number of diseased coronary vessels： normal, 1,2 and 3 group. Results CAG showed normal in 17 cases and there were 25,22,18 cases in 1,2,3 group respectively. The distribution of intracranial stenosis in the groups with degrees of CAD was 23.5% ,28.0% ,59.1% ,66.7% of the patients with normal, 1-,2-,and 3-vessel disease,respectively. There was a stepwise increase in the number of the patients with intracranial stenosis among the patients with increasing severity of CAD（ P 〈0.01）. The prevalence was statistically higher in the CAD patients with multi-vessel disease than those with 1-vessel disease （ P 〈0.05） ,and multi-vessel disease was independent risk factor of intracranial stenosis in the patients with CAD （OR 4. 542,95% CI 1. 434-14. 393, P 〈0.05）. Conclusion There was a stepwise increase in the prevalence of intracranial stenosis among the patients with increasing severity of CAD.

关 键 词：冠状动脉疾病 冠状动脉造影术 超声检查 多普勒 经颅 

分 类 号：R541.1[医药卫生—心血管疾病]