冠心病患者冠状动脉病变程度与颈动脉粥样硬化及脑梗死的关系  

The relationship between coronary artery lesion and carotid atherosclerosis,cerebral infarction in patients with coronary heart disease

作　　者：王维铁 张旭[1] 许日昊[1] 范莹莹[2] 柳克祥[1] 朱志成[1] WANG Wei-Tie ZHANG Xu XU Ri-Hao FAN Ying-Ying LIU Ke-Xiangl ZHU Zhi-Cheng(Department of Cardiovascular Surgery Department of Anesthesiology, the Second Hospital of Jilin University, Changchun, Jilin 130000, China)

机构地区：[1]吉林大学第二医院心血管外科,吉林省长春市130000 [2]吉林大学第二医院麻醉科,吉林省长春市130000

出　　处：《中国动脉硬化杂志》2017年第2期171-174,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨冠心病患者冠状动脉病变程度与颈动脉粥样硬化及脑梗死的关系。方法入选经冠状动脉造影确诊为冠心病的病例319例。将319例冠心病患者按照冠状动脉病变程度分为4组,比较各组之间颈动脉硬化等级积分、Crouse斑块积分、斑块数、脑梗死发生率的差异。另将319例冠心病患者根据有无脑梗死分为两组:脑梗死组、非脑梗死组,比较两组颈动脉斑块性质、颈动脉硬化等级积分、Crouse斑块积分、斑块数的差异。结果3支病变组、左主干病变组的颈动脉硬化等级积分、Crouse斑块积分、斑块数明显高于1支病变组、2支病变组(P<0.05)。3支病变组脑梗死发生率为27.53%,左主干病变组脑梗死发生率为38.27%;1支病变组、2支病变组未发现脑梗死病例。脑梗死组不稳定性斑块发生率显著高于非脑梗死组(90.00%比46.02%,χ2=6.2949,P<0.05)。结论冠心病患者冠状动脉病变程度越严重,颈动脉粥样硬化越重,脑梗死发生率越高。颈动脉不稳定性斑块更易诱发脑梗死。Aim To investigate the relationship between coronary artery lesion and carotid atherosclerosis （ CAS）, cerebral infarction in patients with coronary heart disease. Methods 319 patients with coronary heart disease diagnosed by coronary angiography were selected. The patients with coronary heart disease were divided into four groups according to the degree of coronary artery lesion. The differences of CAS grade score, Crouse plaque score, plaque number, and cerebral infarction incidence were compared in each group. In addition, 319 cases of coronary heart disease were divided into two groups： cerebral infarction group and non cerebral infarction group, according to whether there was cerebral infarction or no. The differences of carotid plaque character, CAS grade score, Crouse plaque score, plaque number were compared between two groups. Results The CAS grade score, Crouse plaque score, plaque number in 3 branchs lesion group and left main coronary lesion group were significantly higher than those in 1 branch lesion group and 2 branchs lesion group （P〈0.05）. The incidence of cerebral infarction was 27.53% in 3 branchs lesion group, and the incidence rate was 38.27% in left main coronary lesion group. Cerebral infarction case was not found in 1 branch lesion group and 2 branchs lesion group. The incidence of unstable plaque in the cerebral infarction group was significantly higher than that in the non cerebral infarction group （90.00% vs 46.02%, x2= 6.2949, P〈0.05）. Conclusions In patient with coronary heart disease, the more serious the coronary artery lesion, the more severe the CAS, the higher the incidence of cerebral infarction. Carotid unstable plaque is more likely to induce cerebral infarction.

关 键 词：冠心病 颈动脉粥样硬化 脑梗死 颈动脉超声 斑块 

分 类 号：R54[医药卫生—心血管疾病]