不同类型冠心病患者颈动脉斑块声学密度定量分析  

Study on Carotid Plaques in Coronary Artery Diseases by Acoustic Densitometry

作　　者：周贵明[1] 周旻[1] 黄灿亮[1] 万征[1] 杜鑫[1] 袁文利[1] 

机构地区：[1]天津医科大学总医院心内科,300052

出　　处：《天津医药》2007年第11期829-831,共3页Tianjin Medical Journal

摘　　要：目的:探讨不同类型冠心病患者颈动脉粥样斑块背向散射积分校正值(CIBS)的差异,评价其对预测冠状动脉(冠脉)事件发生的价值。方法:将100例受试者(均经冠脉造影检查)分为急性心肌梗死36例(AMI组)、不稳定型心绞痛27例(UAP组)、稳定型心绞痛27例(SAP组)以及对照组10例,其中AMI组与UAP组合称为急性冠脉综合征(ACS)组。用二维超声检测颈动脉是否存在斑块,并测量颈动脉内-中膜厚度(IMT);采用声学密度定量技术测量各组颈动脉斑块CIBS。结果:AMI组(83.33%)、UAP组(82.22%)和SAP组(62.96%)斑块的检出率明显高于对照组(P<0.05),AMI组、UAP组和SAP组3组之间差异无统计学意义(P>0.05)。AMI组、UAP组CIBS显著低于SAP组(P<0.01),AMI组和UAP组之间差异无统计学意义(P>0.05);当CIBS≤-8.2dB时预测ACS的敏感度为82%,特异度为81%;AMI组、UAP组和SAP组IMT值均大于对照组(P<0.05)。结论:ACS患者颈动脉斑块CIBS明显低于SAP患者,用声学密度测定颈动脉斑块CIBS有望成为无创性预测ACS的新指标。Objective： To determine the difference of calibrated integrated backscatter（CIBS） of carotid plaque in coronary artery diseases and to evaluate their coronary event. Methods： One hundred subjects were divided into four groups including 36 cases with acute myocardial infarction as AMI group,27 cases with unstable angina pectoris as UAP group,27 cases with stable angina pectoris as SAP group and control group with 10 age-and gender-matched healthy adults. Two-dimensional and Integrated backscatter examinations were performed and following parameters were obtained,the numbers of plaques,IMT,the Calibrated IBS of carotid plaques（CIBS）. Results： The detective rates of carotid plaques were higher in AMI,UAP and SAP groups than that in control group（P 〈 0.05）. There was no significant difference among AMI,UAP and SAP groups. CIBS of carotid plaques in ACS groups was significantly lower than that in SAP group（P 〈 0.01）,and there was no significant difference between AMI and UAP groups. ACS was cognized when CIBS≤-8.2 dB by ROC curve. Compared with the control group,IMT was significantly increased in patients with the coronary artery diseases. Conclusion： CIBS of carotid plaques significantly decreass in patients with ACS,which indicates the structure of coronary plaques by checking CIBS of carotid plaques to indicate ACS.

关 键 词：冠状动脉疾病 声学 颈动脉疾病 动脉硬化 急性病 综合征 

分 类 号：R743.33[医药卫生—神经病学与精神病学]