颈动脉内-中膜厚度检测在老年冠心病患者冠状动脉病变中的预测价值  

Predictive value of carotid artery intima-media thickness in elderly patients with coronary artery disease

作　　者：周瑞莉[1] 陈剑[1] 郭玉萍[1] 王满立[1] 许少兰[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)超声科,广州510080

出　　处：《岭南心血管病杂志》2014年第6期759-761,790,共4页South China Journal of Cardiovascular Diseases

基　　金：2013年广东省医学科研基金指令性课题(项目编号:C201306)

摘　　要：目的采用彩色多普勒超声检测老年冠状动脉粥样硬化性心脏病(冠心病)患者颈动脉内-中膜厚度(intima-media thickness,IMT),探讨其在老年患者冠状动脉病变中的预测价值。方法选择拟诊为冠心病的老年患者121例,按冠状动脉造影结果分组。按冠状动脉狭窄程度分组:阴性对照组(冠状动脉狭窄<50%);50%≤冠状动脉狭窄<70%组;冠状动脉狭窄≥70%组。按累及冠状动脉病变支数分组:阴性对照组(冠状动脉狭窄<50%);单支病变组(仅1支冠状动脉狭窄≥50%);2支病变组(2支冠状动脉狭窄≥50%);多支病变组(3支及以上的冠状动脉狭窄≥50%)。彩色多普勒超声仪测量颈动脉IMT,对不同冠状动脉病变组的颈动脉IMT、斑块发生率进行比较分析。结果阴性对照组、50%≤冠状动脉狭窄<70%组和冠状动脉狭窄≥70%组IMT分别为(0.80±0.22)mm、(0.98±0.17)mm和(1.01±0.25)mm;颈动脉斑块检出率分别为35.0%、94.8%和83.7%。不同冠状动脉狭窄程度组的颈动脉IMT、斑块发生率均显著高于阴性对照组,差异有统计学意义(P<0.05);但不同冠状动脉狭窄程度组各组之间颈动脉IMT、斑块发生率比较,差异无统计学意义(P>0.05)。阴性对照组、单支病变组、二支病变组和三支病变组颈动脉IMT分别为(0.80±0.22)mm、(0.96±0.15)mm、(0.98±0.17)mm和(1.00±0.15)mm;颈动脉斑块检出率分别为35.0%、84.0%、86.7%和83.9%。不同冠状动脉病变支数组的颈动脉IMT、斑块发生率均显著高于阴性对照组,差异有统计学意义(P<0.05);但不同冠状动脉病变支数各组之间颈动脉IMT、斑块发生率比较,差异无统计学意义(P>0.05)。结论彩色多普勒超声测量颈动脉IMT对冠心病有着重要的预测作用,可望为老年冠心病高危人群筛选提供新的临床手段。Objectives To evaluate the predictive value of carotid artery intima-media thickness （IMT） detected by color Doppler ultrasound in elderly patients with coronary heart disease.Methods Totally 121 elderly patients with suspected coronary heart disease were enrolled in this study.They were grouped according to the results of coronary angiography.According to the degree of coronary artery stenosis,they were divided into 3 groups：negative control group （coronary artery stenosis＜50％）; 50％≤coronary artery stenosis＜70％ group and coronary artery stenosis ≥70％ group.According to the number of involved coronary branches,they were divided into 4 groups：negative control group （coronary artery stenosis＜50％）; single branch lesion group （only 1 coronary artery stenosis ≥ 50％）; two-branch lesion group （2 coronary artery stenoses≥50％）; multiple branch lesion group （3 or more coronary stenoses≥50％）.IMT and plaque in common carotid arteries were measured by ultrasound and compared among the groups.Results IMT of control group,50％ ≤ coronary artery stenosis＜70％ group and coronary stenosis ≥ 70％ group were （0.80±0.22） mm,（0.98±0.17） mm and （1.01±0.25） mm respectively; incidence rates of plaque in common carotid arteries were 35.0％,94.8％ and 83.7％ respectively.IMT and incidence rates of plaque in common carotid arteries were significantly higher in groups with different degrees of coronary artery stenosis than in control group （P＜0.05）,but they had no significant difference among groups with different degrees of coronary artery stenosis （P＞0.05）.IMT and incidence rates of plaque in common carotid arteries in negative control group,single branch lesion group,two-branch lesion group,multiple branch lesion group were （0.80±0.22） mm,（0.96±0.15） mm,（0.98±0.17） mm,（1.00±0.15）mm and 35.0％,84.0％,86.7％,83.9％ respectively.IMT and incidence rates of plaque in common carotid arteries in groups with different numbers

关 键 词：冠状动脉疾病 颈动脉内-中膜厚度 颈动脉彩色多普勒 冠状动脉造影术 老年 

分 类 号：R541.4[医药卫生—心血管疾病]