颈动脉、同型半胱氨酸、酯蛋白（a）预测冠状动脉粥样病变的探讨  

prediction of coronary atherosclerotic heart disease based on carotid artey,Lp（a）and Hcy

作　　者：熊小亚 宋兵[2] 刘瑞生[2] 唐汉博[2] 邢旺[2] 

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院心血管外科,甘肃兰州730000

出　　处：《中西医结合心血管病电子杂志》2014年第3期20-22,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的：探讨颈动脉、同型半胱氨酸、酯蛋白（a）诊断作为预测冠状动脉粥样硬化性心脏病（简称冠心病）诊断指标的临床可行性。方法对经冠脉造影确诊191例冠心病患者，做双侧颈动脉彩色超声检查及同型半胱氨酸、酯蛋白（a）水平测定，研究颈动脉与同型半胱氨酸、酯蛋白（a）在预测冠心病的可行性。结果根据颈动脉彩超检查结果显示72．25％的冠心病患者颈动脉处增厚形成斑块，斑块的发生率达62．72％。有斑块患者的同型半胱氨酸、酯蛋白（a）指标高于没有斑块患者P＜0．05。结论颈动脉彩超检测结合同型半胱氨酸、酯蛋白（a）检测对冠心病的预测性诊断具有一定的指导性，但作为预测性诊断的标准仍需要大量的临床试验和科学的理论基础。Objective To investigate the clinical feasibility of using carotid artery,lipoprotein（a）[Lp（a）]and plaques homocys-teine（Hcy）as the diagnostic indicators for coronary atherosclerotic heart disease（CHD）.Methods 191cases of CHD confirmed with coronary angiograpHy were given bilateral carotid color Doppler ultrasound examination,Lp（a）and Hcy,The feasibility of using neck artery plaque score,Lp（a）and Hcy as prediction indicators for cormary heart disease was studied.Results Carotid colr Doppler ultrasound exami-nation results showed 72.25% of coronary heart disease patients demonstrated carotid artery thickening and plaque formation,with a plaque occurrence rate of 62.72%.Lp（a）and Hcy was significantly higher in patients with plaque than in patients without plaque （P〈0.05 ）. Conclusion catotid ultrasonograpHy detection combined with Lp（a）and Hcy test can provide guidance for the predictive diangnosis of coronary artery disease,but the criteria of prediction with both indicators still need to be based on a large number of clinical trials and scientific theorrtical foundation.

关 键 词：冠心病 颈动脉 彩色超声 同型半胱氨酸 酯蛋白(a) 

分 类 号：R541.4[医药卫生—心血管疾病]