颈脑一体化超声对颅-内外动脉粥样硬化狭窄性病变患者冠状动脉狭窄的预测价值  

The Predictive Value of Integrated Cervical Cerebral Ultrasound on Coronary Stenosis of Patients with Intracranial and Extracranial Atherosclerotic Stenosis

作　　者：沈健 张皓然[1] 王枫[1] 刘艳伟[1] 李莎 杨绍石 SHEN Jian;ZHANG Haoran;WANG Feng(The Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《河北医学》2021年第7期1166-1169,共4页Hebei Medicine

基　　金：河北省承德市科学技术研究与发展计划项目,(编号:202006A081)。

摘　　要：目的:通过颈脑一体化超声(经颅多普勒超声(TCD)和颈动脉血管超声)联合检查,探讨颅内-外动脉血管狭窄性病变与冠状动脉血管狭窄性病变的关系。方法:对186例经我院冠状动脉造影检查确诊为冠状动脉狭窄的患者分成A、B两组,A组:97例(冠状动脉狭窄≤2支);B组:89例(冠状动脉狭窄≥3支),采用颈脑一体化超声(经颅多普勒超声(TCD)和颈动脉血管超声)检查颅-内外动脉,比较两组患者的颅内动脉血管(A组:1067支,B组979支)、颅外动脉血管(A组:776支,B组712支)的血管狭窄情况。结果:A组患者颅内-外动脉血管狭窄性病变的检出率分别为5.2%(55/1067)、10.18%(79/776);B组患者颅内-外动脉血管狭窄性病变的检出率分别为8.5%(83/979)、17.13%(122/712),两组比较差异均有统计学意义(P=0.003,P=0.001)。A组患者颅内-外动脉狭窄程度分别为:轻度狭窄52支(39%)、中度狭窄47支(35%)、重度狭窄或闭塞35支(26%);B组患者颅内-外动脉狭窄程度分别为:轻度狭窄61支(30%)、中度狭窄65支(32%)、重度狭窄或闭塞79支(38%),两组间重度狭窄或闭塞性血管病变相互比较,差异有统计学意义(P=0.018)。结论:颅内-外动脉血管狭窄程度的加重与冠状动脉狭窄的严重程度及其累及的血管支数的增加呈正相关性,可以通过颈脑一体化超声(经颅多普勒超声(TCD)和颈动脉血管超声)检查颅内-外动脉血管狭窄性病变的情况,来评估冠状动脉血管狭窄性病变的严重程度。Objective:To investigate the relationship between intracranial and extracranial atherosclerotic stenosis by using transcranial doppler(TCD)and carotid artery ultrasound.Methods:A total of 186 patients with coronary artery stenosis confirmed by coronary angiography in our hospital were divided into group A,97 cases(coronary artery stenosis≤2 branches)and group B,89 cases(coronary artery stenosis≥3 branches).Patients in both groups were examined by transcranial Doppler ultrasound(TCD)and carotid artery ultrasound.The stenosis of intracranial artery(group A:1067,group B:979),extracranial artery(group A:776,group B:712)were compared between the two groups.Results:The detection rates of intracranial and extracranial arterial stenosis were 5.2%(55/1067)and 10.18%(79/776)in group A,and 8.5%(83/979)and 17.13%(122/712)in group B,with statistical significance(P=0.003,P=0.001).In group A,52(39%)were mild stenosis,47(35%)were moderate stenosis,35(26%)were severe stenosis or occlusion;61(30%)were mild stenosis,65(32%)were moderate stenosis,79(38%)were severe stenosis or occlusion.The difference between the two groups was statistically significant(P=0.018).Conclusion:In patients with coronary heart disease,with the aggravation of intracranial and extracranial artery stenosis,the severity of coronary artery stenosis and the number of involved vessels are also increasing,and the two are positively correlated.We can evaluate coronary artery stenosis by examining intracranial and extracranial artery stenosis with integrated carotid brain ultrasound(TCD and carotid ultrasound).

关 键 词：颈脑一体化超声 颅内-外动脉狭窄性病变 冠状动脉狭窄性病变 

分 类 号：R743[医药卫生—神经病学与精神病学]