颈动脉粥样斑块超声指标与冠状动脉粥样硬化的相关性分析  

Correlation between carotid atherosclerosis and coronary atherosclerosis in patients with coronary heart disease

作　　者：李景 张明智 张循 刘家开 罗利 Li Jing, Zhang Mingzhi, Zhang Xun, Liu Jiakai, Luo Li.(Function Testing Lab, the Second Affiliated Hospital of Chengdu Medical College, the 416 nuclear hospital, Chengdu 610051, China)

机构地区：[1]成都医学院附属第二医院.核工业四一六医院功能检查科,成都610057 [2]成都医学院附属第二医院.核工业四一六医院心内科,成都610057 [3]四川大学华西医院超声科,成都610051

出　　处：《中国循证心血管医学杂志》2018年第5期581-584,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析超声检测颈动脉内-中膜厚度(IMT)对诊断冠状动脉粥样硬化病变的价值,及冠状动脉粥样硬化Gensini评分与颈动脉粥样硬化Crouse积分的相关性,为冠状动脉粥样硬化性心脏病(冠心病)的防治提供简单易行的检测依据。方法选取成都医学院附属第二医院及四川大学华西医院于2015年1月~2017年1月心血管内科诊治并行冠状动脉造影(CAG)检查的患者114例,根据CAG检查结果将其分为非冠心病组(n=40)与冠心病组(n=74),再根据冠状动脉病变支数将冠心病组分为三个亚组,比较非冠心病组、冠心病组的颈动脉IMT、颈动脉斑块Crouse积分,探讨Gensini评分与Crouse积分的关系;评估颈动脉超声诊断冠心病临床价值。结果冠心病组的IMT较非冠心病组显著增厚,差异具有统计学意义(P<0.05),其三个亚组(单支病变亚组、两支病变亚组、三支病变亚组)的IMT分别为(0.94±0.15)mm、(1.17±0.17)mm、(1.21±0.23)mm;非冠心病组Crouse积分为(1.11±0.75)分,Gensini积分为(0.0±0.0)分;冠心病组Crouse积分为(5.14±3.41)分,Gensini积分为(22.2±11.02)分,冠心病组上述指标均高于非冠心病组(P<0.05);相关性分析显示Crouse积分与Gensini积分呈正相关(r=0.354,P=0.001);诊断实验四格表显示颈动脉超声诊断冠心病的诊断符合率为86.0%。结论利用颈动脉超声检查的指标去诊断冠状动脉粥样硬化病变严重程度与颈动脉粥样硬化程度的相关性,具有可实践性,值得临床推广。Objective To study the intima-media thickness（IMT） of carotid artery by ultrasonography, and to analyze the correlation between Gensini score of coronary atherosclerosis and Crouse score of carotid atherosclerosis, and to provide evidence for the prevention and treatment of coronary heart disease（CHD）. MethodsA total of 114 patients undergoing coronary angiography（CAG） examination from January 2015 to January 2017 were enrolled. According to the results of CAG test, 114 cases were divided into non CHD group（n=40） and CHD group（n=74）. According to the number of coronary lesions, the CHD group were divided into three subgroups. Carotid artery IMT and carotid plaque Crouse scores of non-coronary heart disease group and coronary heart disease group were compared to discuss the relationship between Gensini score and Crouse score; and the clinical value of carotid ultrasound in the diagnosis of coronary heart disease was evaluated. Results The IMT of CHD group was thicker than that of non CHD group, and the difference was statistically significant（P〈0.05）. The IMTs of the three subgroups（single branch, two branch and three subgroup） were 0.94±0.15 mm, 1.17±0.17 mm and 1.21±0.23 mm. Crouse score of non CHD group was 1.11. The Gensini score of non CHD group was（0.0±0.0）. The Crouse score of CHD group was（5.14±3.41）, Gensini score of CHD group was（22.2±11.02）. The above indexes in CHD group were higher than those of non CHD group（P〈0.05）. The correlation analysis showed that the Crouse integral was positively correlated with the Gensini score（r=0.354, P=0.001）. The diagnostic accuracy of carotid ultrasound diagnosis of CHD was 86.0%. Conclusion The correlation between the severity of coronary atherosclerosis and the degree of carotid atherosclerosis can be diagnosed by using the indexes of carotid ultrasonography, and it is practical and worthy of clinical promotion.

关 键 词：超声 冠心病 颈动脉粥样斑块 冠状动脉粥样斑块 

分 类 号：R541.4[医药卫生—心血管疾病]