超声检测颈动脉斑块与冠心病的相关性研究  

Studies on the relationship between carotid plague defected by ultrasonography and coronary artery disease

作　　者：陈莉[1] 吴婷[2] 李慎义[1] 杨智利[1] 赵景[1] 

机构地区：[1]南昌大学第一附属医院超声诊断科,江西南昌330006 [2]南昌大学第二附属医院超声诊断科,江西南昌330006

出　　处：《中国现代医学杂志》2013年第3期48-51,共4页China Journal of Modern Medicine

基　　金：江西省教育厅科学技术研究项目(No:GJJ11369)

摘　　要：目的就颈动脉内中膜厚度、颈动脉粥样斑块的稳定性与冠心病的相关性进行研究。方法选择经冠状动脉造影检查确诊的冠心病患者87例(其中单支冠状动脉病变A组33例,双支冠状动脉病变B组27例,三支冠状动脉病变C组27例)及正常对照组29例,平均年龄(63.90±8.89)岁,所有患者均行双侧颈动脉彩超,测量颈动脉内中膜厚度、判断斑块的稳定性,根据结果进行统计学分析。结果冠心病各组的颈动脉内中膜厚度均高于对照组,且随着冠脉病变支数的增加,颈动脉IMT值也随之增加。冠心病组与对照组颈动脉内中膜厚度之间有显著性差异(t=6.504,P<0.001),冠心病各组间颈动脉内中膜厚度也具有统计学意义,单支病变组与双支病变组、双支病变组与三支病变组均有显著性差异(t1.2=-4.681,P1.2<0.001;t2.3=-3.131,P2.3=0.003)。颈动脉斑块的检出率在冠心病组与对照组中均较高,但两组并无明显差异(P=0.511),冠心病组中有54例患者有颈动脉斑块,其中32例的颈动脉斑块属于不稳定性斑块,而对照组中有16例患者有颈动脉粥样斑块,其中只有2例为不稳定型斑块,两者之间有显著性差异(P=0.008)。在单支病变组、双支病变组及三支病变组中不稳定斑块例数也随病变支数的增加而增加,且单支病变组与双支病变组、双支病变组与三支病变组不稳定性斑块之间有着显著性差异(P1.2=0.037,P2.3=0.028)。结论随着颈动脉内中膜厚度值增大及不稳定斑块数量的增加,冠状动脉病变支数增加。冠状动脉病变支数与斑块数量无关,但与斑块的稳定性密切相关。[ Objective ] Through the detection of the intima-media thickness （IMT） in the carotid artery, the sta- bility of the plague, discuss the relationship between these factors and the Coronary Atherosclerotic Heart Disease （CAD）. [Methods] 87 patients with coronary artery disease （including 33 patients of one-vessel group, 27 patients of two-vessel group, 27 patients of three-vessel group） and 29 patients without coronary artery disease confirmed with coronary angiography, all patients had been detected carotid artery IMT and the carotid plagues using high-fre- quency Ultrasound, Finally, do the Statistic analysis of results. [ Results ] The results showed that the carotid artery IMT in CAD group was obviously higher than in the control group （t=6.504, P 〈0.001）, and there was significant dif- ferent between one-vessel group and two-vessel group, also was between two-vessel group and three-vessel group （tl.2=-4.681, P1.2〈0.001; t2.3=-3.131, P2.3=0.003）. The detection rate of the plagues were also high in CAD group and the control group, there was no significant different between them （P =0.511）. In CAD group, 32 out 54 patients had instability plaques, while 2 out 16 patients in the control group, there was significant different between them （P=0.008）. The percentage of the instability plaques increased with group category, and there was significant different between one-vessel group and two-vessel group （P =0.037）, also was between two-vessel group and three-vessel group （P =0.028）. [ Conclusion ] With the augment of carotid artery IMT, the mount of the instability plaques and the pathological branches of coronary arteries were increasing. The character of carotid atherosclerosis and Coronary heart disease has a positive correlation. The pathological branches of coronary arteries were not relation to the mount of plaques, but were close related to character of carotid atherosclerosis.

关 键 词：内中膜厚度 颈动脉粥样斑块 冠心病 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.41[医药卫生—诊断学]