颈动脉超声联合血清同型半胱氨酸在冠状动脉粥样硬化性心脏病诊断中的应用价值  

The value of carotid ultrasonography combined with serum homocysteine in the diagnosis of coronary atherosclerotic heart disease

作　　者：胡瀚中[1] 侯盼[1] 曹永政[1] 

机构地区：[1]遵义医学院附属医院,贵州遵义563003

出　　处：《吉林医学》2017年第7期1245-1248,共4页Jilin Medical Journal

摘　　要：目的:探讨颈动脉超声联合血清同型半胱氨酸(Hcy)在冠状动脉粥样硬化性心脏病(CAD)诊断中的应用价值。方法:选取161例经冠脉造影证实为CAD的患者为研究对象,作为观察组,另选取同期161例健康体检者为对照组,比较两组患者颈动脉超声结果、血清同型半胱氨酸(Hcy)水平的差异,分析与冠状动脉狭窄相关的危险因素。结果:观察组与对照组比较,颈动脉内-中膜厚度(IMT)分别为(1.25±0.19)mm∶(0.84±0.20)mm,Crouse斑块积分分别为(8.87±2.89)分、(3.86±1.44)分,血清Hcy水平分别为(17.59±2.82)μmol/L、(6.29±2.99)μmol/L),差异均具有统计学意义(P<0.05);观察组中冠状动脉中度狭窄、重狭窄、闭塞三个亚组比较,颈动脉内-中膜厚度(IMT)、Crouse斑块积分呈明显的递增趋势(P<0.05);而血清Hcy水平与CAD患者冠脉狭窄程度无相关性(P>0.05)。结论:颈动脉超声联合Hcy检测可以作为CAD的临床诊断筛查手段,同时颈动脉超声还能预判CAD冠脉的狭窄程度。Objective To investigate the value of Carotid ultrasound combined serum homocysteine （H e y） applied in the di-agnosis of coronary atherosclerotic cardiopathy. Method 161 patients with CAD praved by coronary angiography were selected as study group. Meanwhile,the control group was composed of 161 healthy people. Then,we compared the Carotid ultrasound results and discrimination of serum homocysteine （hey） between study group and control group,and analyze the related risk factor of cor-onary stenosis. Results Compared with control group, the intima - media thickness of carotid artery [（ 1. 25 ± 0. 19 ） mm V S （0. 84 ±0. 20） mm]、Crouse plaque score （8. 87 ± 2. 89 V S 3. 86 ± 1. 44 ） 、 Hey levels [ （1 7 . 59 ± 2. 82） jjimol/L V S （6. 29 ± 2. 99 ） ｜jLmol/L] had statistical significance （ P 〈 0. 05 ）. In the CAD group, the three subgroups of moderate coronary artery steno-sis ,severe stenosis and occlusion were compared,the intima - media thickness of carotid artery-,Crouse plaque score,Hcy lev-els. With the severity of coronary artery stenosis increasing, the intima - media thickness of carotid artery and Crouse plaque score were increased also（P 〈0. 05） ;But the serum Hey levels did not have relationship with the levels of coronary artery steno-sis （P 〉0. 05）. Conclusion The carotid artery ultrasound combined with Hey can be used to screen up the CAD in clinical diag-nosis, and the carotid artery ultrasound also can be applied into predict the degree of coronary artery stenosis of CAD.

关 键 词：颈动脉超声 Hcy CAD AS IMT CAG 

分 类 号：R541.4[医药卫生—心血管疾病]