冠心病合并颈动脉狭窄的危险因素及动脉斑块性质分析  

Prevalence and risk factors of coronary heart disease combined with carotid artery stenosis

作　　者：刘贝贝[1] 易立[1] 张拥波[1] LIU Bei-bei;YI Li;ZHANG Yong-bo(Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院神经内科,北京100050

出　　处：《临床和实验医学杂志》2024年第17期1802-1806,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金项目(编号:81671191)。

摘　　要：目的 分析冠心病合并颈动脉狭窄(CAS)的患病率、危险因素及颈动脉斑块的性质。方法 回顾性连续纳入2019年3月至2024年2月首都医科大学附属北京友谊医院收治的经冠状动脉造影确诊为冠心病并同期行颈动脉超声检查的患者。根据任一主要冠状动脉狭窄程度≥50%定义为冠心病,颈动脉狭窄程度≥50%定义为CAS。明确冠心病合并CAS的患病率、严重程度及颈动脉斑块特征,采用多因素Logistic回归分析对冠心病联合CAS的共病危险因素进行分析。结果 共纳入冠心病患者1 062例,其中合并CAS患者130例,冠心病合并CAS的患病率为12.24%。年龄、既往短暂性脑缺血发作(TIA)/脑卒中、吸烟和冠脉多支病变是冠心病合并CAS的独立危险因素(P<0.05),且随冠脉狭窄程度增加CAS程度加重(P<0.05)。CAS组患者颈动脉斑块回声以混合回声为主,斑块钙化及溃疡的比率明显高于无CAS组(P<0.05)。结论 冠心病合并CAS的患病率为12.24%,年龄、既往短暂性脑缺血发作/脑卒中、吸烟和冠脉多支病变是冠心病合并CAS的独立危险因素;颈动脉斑块多有钙化和溃疡,需要加强对可控危险因素的预防。对冠心病患者特别是手术患者应积极行颈动脉血管检查。Objective To investigate the prevalence and risk factors of coronary heart disease combined with carotid artery stenosis(CAS).Methods Patients who underwent coronary angiography due to the suspicion of coronary artery heart disease in Beijing Friendship Hospital,Capital Medical University from March 2019 to February 2024 were retrospectively recruited.Carotid ultrasonography was performed simultaneously.Coronary artery heart disease was defined as a lumen diameter of stenosis≥50%in more than 1 major epicardial artery.And CAS was defined as stenosis≥50%.The prevalence of coronary artery heart disease combined with CAS,the stenotic severity of coronary and carotid artery,and carotid plaque characteristics between two groups were investigated.Multivariate Logistic regression model was used to identify the risk factors of the combination of coronary heart disease and CAS.Results A total of 1062 patients confirmed with coronary heart disease were included.Among these patients,130(12.2%)were diagnosed with CAS.Independent risk factors of the combination of coronary heart disease and CAS were age,previous transient ischemic attack(TIA)/stroke,cigarette smoking,and coronary multi-vessel disease(P<0.05).The degree of CAS increased notably with the severity of coronary artery heart disease.The character of carotid artery plaques in CAS group were mainly mixed echo,and the prevalence of carotid plaques with calcification and ulceration was higher in CAS group than that of non-CAS group(P<0.05).Conclusion The prevalence of coronary artery heart disease concomitant with CAS is on rise.The stenotic degree of coronary heart disease and CAS is significantly correlated.Carotid artery examination is highly recommended for patients with coronary heart disease,especially before cardiac surgery,and vice versa.

关 键 词：冠心病 颈动脉狭窄 患病率 危险因素 颈动脉斑块 

分 类 号：R541.4[医药卫生—心血管疾病] R543.4[医药卫生—内科学]