冠状动脉粥样硬化狭窄与脑动脉粥样硬化狭窄的关系  

The relationship between coronary atherosclerotic stenosis and cerebral atherosclerotic stenosis

作　　者：魏嘉平[1] 李康[1] 赵虹[1] 何冀芳[1] 温静[1] 周春燕[1] 吴晓光[2] 汪家瑞[1] 李慎茂[3] 张志勇[3] 凌峰[3] 

机构地区：[1]首都医科大学宣武医院心内科,北京100053 [2]首都医科大学宣武医院流行病学和社会医学部 [3]首都医科大学宣武医院介入放射诊断治疗中心

出　　处：《中华心血管病杂志》2007年第10期889-892,共4页Chinese Journal of Cardiology

摘　　要：目的探讨颈动脉和(或)脑动脉粥样硬化狭窄与冠状动脉狭窄的关系。方法选择34例心内科住院伴有脑缺血症状、接受冠状动脉造影并颈动脉造影或全脑血管造影的患者。根据造影动脉管腔狭窄的程度分别分成三个亚组,冠状动脉狭窄分为轻度狭窄组(5例)、中度狭窄组(4例)、重度狭窄组(25例);脑血管狭窄分为轻度狭窄组(6例)、中度狭窄组(4例)、重度狭窄组(24例)。结果冠状动脉狭窄与颈动脉或椎动脉狭窄程度分布一致,冠状动脉血管重度狭窄者25例,脑血管重度狭窄者24例,二者间差异无统计学意义;冠状动脉 Califf 危险记分≥2分者,脑血管中、重度狭窄的比例高达92%,且随着冠状动脉狭窄程度的加重,颈动脉及脑血管狭窄的程度亦加重。随访发现中重度双重狭窄(冠状动脉狭窄同时伴有脑动脉狭窄)病变的心脑事件发生明显增多,其中双重度狭窄死亡3例。结论颈动脉或椎动脉粥样硬化性狭窄的发生率及程度与冠状动脉狭窄是平行的。故对冠状动脉狭窄合并颈动脉和(或)椎动脉粥样硬化狭窄者,尤其伴有高血压、糖尿病、吸烟等多重危险因素时,应给予积极强化的联合治疗以减少心脑血管事件的发生。Objective To observe the relationship between coronary and carotid/cerebral atherosclerotic stenosis. Methods Carotid/aortocranial angiography and coronary angiography were performed in 34 CAD patients complicated with symptomatic cerebral ischemia. Patients were divided into 3 subgroups according to the extent of arterial stenosis determined by angiography. There were 5 light, 4 moderate and 25 severe stenosis determined by coronary angiography and there were 6 light, 6 moderate and 24 severe stenosis determined by carotid/aortocranial angiography. Results The extent of coronary artery stenosis was parallel to the carotid artery or vertebral artery stenosis. Twenty-four patients out of 25 patients with severe coronary stenosis had severe cerebrovascular stenosis （P = 0. 873 ）. The coincident rate was as high as 92% for patients with moderate or severe cerebrovascular stenosis whose Califf risk scores of coronary artery were more than or equal to 2. The follow-up study showed the incidence of cardiovascular event and cerebrovascular event increased significantly in the patients with moderate to severe coronary and cerebral arteries stenosis and 3 patients with severe stenosis found in both coronary and cerebral arteries died during follow up. Conclusion The incidence and severity of coronary artery stenosis is parallel with carotid artery or vertebral artery stenosis.

关 键 词：冠状动脉硬化 颈动脉狭窄 脑血管造影术 心血管造影术 预测 

分 类 号：R743.3[医药卫生—神经病学与精神病学]