颈动脉内中膜增厚及斑块对中风和冠心病事件的影响  

Carotid intima- media thickness and plaques on the impact of stroke and coronary heart disease events

作　　者：孔维敏[1] 刘林[2] 薛存屹 高昕[2] 欧胜胜[2] 楼青青[2] 

机构地区：[1]南京中医药大学护理学院,江苏南京210000 [2]南京中医药大学附属中西医结合医院,江苏南京210028 [3]杭州市第九中学,浙江杭州310000

出　　处：《中国热带医学》2016年第1期76-79,共4页China Tropical Medicine

摘　　要：目的通过多普勒超声对颈动脉内中膜厚度(IMT)和颈动脉斑块进行检测,探讨IMT、颈动脉斑块对中风和冠心病事件的影响。方法选2015年5月至7月在南京中医药大学附属中西医结合医院心血管内科和神经内科行颈动脉超声的住院患者338例,按IMT是否增厚分IMT增厚组与无IMT增厚组。按颈动脉中是否有斑块分为有斑块组与无斑块组。计算IMT增厚、颈动脉斑块对中风和冠心病发生事件的比值(OR值)。结果 338名患者中235位(69.53%)有IMT增厚,有IMT增厚的患者较无IMT增厚的患者中风事件的发生率增加5.102倍(95%CI,2.858-9.110,P<0.01),冠心病事件的发生率增加2.082倍(95%CI,1.221-3.551,P=0.007)。338名患者中215位(63.6%)有颈动脉斑块,有颈动脉斑块的患者较无颈动脉斑块的患者中风事件的发生率增加4.728倍(95%CI,2.793-8.003,P<0.01),冠心病事件的发生率增加2.439倍(95%CI,1.462-4.070,P=0.001)。结论心内科和神经内科住院患者颈动脉内中膜增厚及颈动脉斑块的检出率高;IMT增厚对中风事件的影响大于颈动脉斑块,颈动脉斑块对冠心病事件的影响大于IMT增厚。Objective To explore carotid intima-media thickness （IMT） and carotid plaques measured by ultrasound, and to find out their influence on stroke and coronary heart disease events. Methods A total of 338 hospitalized patients with carotid ultrasound were selected in the department of Cardiology and Neurology, Hospital on Integration of Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine between May and July 2015. According to whether the IMT thickened, patients were divided into IMT thickening group and no IMT thickening group. According to whether with plaque in carotid artery, patients were divided into plaque group and no plaque group. Results In 338 patients, of which 235 （69.53%） cases were with IMT thickened, the incidence of stroke events in patients with IMT thickening were increased 5.102 times than patients with no IMT thickening （95% CI： 2.858-9.110, P〈0.01）, the incidence of coronary heart disease events were increased 2.082 times （95% C1：1.221-3.551, P=0. 007）. In 338 patients, of which 215 （63.6%） with carotid plaques, the incidence of stroke in patients with carotid plaques event were increased 4.728 times than no carotid plaques in patients （95% CI： 2.793-8.003, P〈0.01）, the incidence of coronary heart disease events was increased 2.439 times （95% C1：1.462-4.070,P= 0.00l）. Conclusion The detection rate of carotid artery intima-media thickness and carotid artery plaque are high in hospitalized patients of cardiology and neurology; IMT thickening for stroke events is greater than the effect of carotid plaques, the effect of carotid artery plaque is greater than the IMT thickening on coronary heart disease events.

关 键 词：颈动脉内中膜厚度 斑块 中风 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]