超声检查冠心病患者颈动脉、股动脉、髂总动脉内-中膜厚度的研究  

The study of intimal-medial thickness (IMT)of carotid, femoral and common iliac arteries in patients with coronary artery atherosclerosis

作　　者：耿斌[1] 曹铁生[1] 段云友[1] 

机构地区：[1]第四军医大学唐都医院超声诊断科,西安710038

出　　处：《中华超声影像学杂志》2001年第5期295-297,共3页Chinese Journal of Ultrasonography

摘　　要：目的　探讨冠心病患者颈动脉 (CA)、髂总动脉 (CIA)、股动脉 (FA)内 -中膜厚度 (IMT)的变化规律。方法　对 115例冠状动脉造影受检者进行CA、CIA、FA超声检查 ,对各动脉IMT、粥样硬化斑块发生率及心血管危险因素同冠状动脉造影结果进行单因素 t检验、χ2 检验和多因素的多元逐步回归、Logistic模式回归分析。结果　冠脉造影阳性组CA、CIA、FA的IMT和粥样硬化斑块发生率显著高于阴性组 (P <0 .0 1) ;Logistic回归显示 ,CA、CIA和FA粥样硬化与冠心病的发生呈显著性相关 (β分别为 2 .147、2 .813和 3.2 0 4,P 分别 <0 .0 5、<0 .0 1、<0 .0 0 5 ;比数比分别为 8.797、16 .6 6 6和 2 4.6 42 ,P 均 <0 .0 0 1) ;逐步回归显示 ,CIA、FA的IMT与冠脉造影Gensini′s评分显著正相关 (P<0 .0 0 0 1) ,CIA、FA的IMT每增加 1mm ,LOG(1+Gensini′s评分 )分别增加 0 .2 0、0 .19;CA的IMT与LOG(1+Gensini′s评分 )也呈较显著相关 (P <0 .0 5 )。CIA粥样硬化与急性心肌梗死呈显著正相关 (P <0 .0 5 )。CA、CIA、FA粥样硬化对冠心病的阳性预测值分别为 75 %、87%和 88% ,两处为阳性的阳性预测值高达 92 %～ 98% ,三处均为阳性的阳性预测值为 10 0 %。结论　CIA、FA粥样硬化是两个独立的、与冠心病显著相关的因素 ,可作为?Objective To investigate regularity of intimal medial thickness(IMT)of extracoronary artery (including carotid, femoral and common iliac arteries ) in patients with coronary artery disease (CAD).Methods Atherosclerosis of carotid, femoral and common iliac arteries was investigated with ultrasound in 115 subjects undergone coronary arteriography (CAG). Stepwise multiple regression analysis and Logistic regression were carried out between the results of extracoronary artery ultrasound examination and CAG.Results The IMT and incidence of carotid, common iliac and femoral atherosclerostic plaques in patients with positive CAG were significantly higher than the subjects with negative CAG (P< 0.01 ); Logistic regression indicated that the presence or absence of carotid, common iliac, femoral atherosclerosis was closely correlated with CAD (β were 2.147 , 2.813 and 3.204 respectively,P< 0.05 ,< 0.01 ,< 0.005 respectively. Odds ratio were 8.797 , 16.666 and 24.642 respectively,P< 0.001 ). Stepwise multiple regression analysis showed that common iliac and femoral IMT were closely associated with LOG (1+ Gensini′s score) (P< 0.0001 ). For each increased 1 mm of common iliac and femoral IMT, the LOG (1+ Gensini′s score) increased 0.20 and 0.19 respectively. Furthermore, the carotid artery IMT was also partly associated with LOG (1+ Gensini′s score) (P< 0.05 ). Common iliac atherosclerosis was closely correlated with occurrence of acute myocardial infarction,the positive predictive value of carotid, common iliac, femoral atherosclerosis was 75%, 87%, 88% respectively, the positive predictive values for 2 sites and 3 sites were 92%～98% and 100% respectively.Conclusions The presence or absence and the extent and severity of coronary artery atherosclerosis can be predicted through investigating extracoronary artery atherosclerosis.Common iliac and femoral arteries can be asurrogate and window for studying the occurrence, pro

关 键 词：超声检查 冠状动脉疾病 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]