超声检测颈动脉粥样硬化与冠心病心脏事件的关系  

Relationship between carotid arterosclerosis and cardiac events by ultrasound

作　　者：徐欣[1] 杨志健[2] 郑义通[1] 徐默玲[1] 杨承健[1] 雍永宏[2] 

机构地区：[1]无锡市第二人民医院心血管内科,江苏无锡214002 [2]江苏省人民医院心血管内科,江苏南京210001

出　　处：《临床荟萃》2003年第15期844-847,共4页Clinical Focus

摘　　要：目的　探讨颈动脉粥样硬化与冠状动脉粥样硬化的相关性 ,评价超声检测颈动脉粥样硬化对冠心病心脏事件预测的可能性。方法　将 2 33例疑是冠心病和心肌梗死患者行选择性冠状动脉造影及颈动脉超声检查 ,同时随访其心脏事件发生情况。分析颈动脉内中膜厚度 (IMT)及斑块与冠心病、冠心病危险因素及冠心病心脏事件发生情况的相关性。结果　 2 33例患者有 14 0例颈动脉超声阳性即IMT≥ 0 .8mm(6 0 .1% ) ,颈动脉超声阳性与性别、年龄、体重指数、糖尿病、高血压、痛风、吸烟、家族史、不稳定型心绞痛、心肌梗死、经皮冠状动脉腔内成形术、冠状动脉搭桥术、冠状动脉造影二支病变、冠状动脉造影三支病变、超声心动图异常、运动平板试验异常、异常Q波、ST段改变呈正相关 (P <0 .0 5 ) ;2 33例随访率为 94 .8% ,有 4 6例患者发生 4 8件心脏事件 ,其发生与体重指数、不稳定型心绞痛、冠状动脉造影阳性、冠状动脉造影二支病变、冠状动脉造影三支病变、颈动脉超声阳性、颈动脉斑块呈正相关 ,且关系密切 (P <0 .0 5 ) ;多因素非条件Logistic回归分析排除混杂因素影响 ,显示颈动脉超声阳性与阴性患者的心脏事件差别有统计学意义 (P <0 .0 5 )。结论　颈动脉粥样硬化与冠心病及冠心病危险因素之间关系密切 ,颈动脉超声?Objective To investigate the relationship between carotid atherosclerosis(CA) and coronary artery disease(CAD),and evaluate the value of CA in predicting cardiac events in patients with CAD.Methods Angiography and carotid ultrasound was performed on 233 patients with suspected CAD disease and simultaneously their cardiac events were followed up.Relationship between intima media thickness(IMT) and plague type with CA, CAD,the risk factors of CAD,cardiac events was analysed.Results 140 of 233 patients( 60.1% ) had positive findings with IMT≥ 0.8 mm.Positive findings of carotid ultrasound had positive correlation with sex,age,body mass index,diabetes mellitus,hypertension,gout,smoking,family history,unstable angina pectoris,myocardial infarction,percutaneous transluminal coronary angioplasty,coronary artery bypass grafting,two vessel disease and three vessel disease,abnormal ultrasound cardiogram(UCG),erercise training(EET),abnormal Q wave and ST segment deviation in electrocardiogram(ECG)(P< 0.05 ); 221 patients( 94.8% ) were followed up.46 patients suffered from 48 cardiac events,and they had were positive correlations with body mass index,unstable angina pectoris,positive findings in angiography,two vessel disease,three vessel disease and carotid plagues(P< 0.05 );Multiple factor and non condition logistic regression,excluding influence of promiscuous factors,showed statistic differences between carotid ultrasound and cardiac events(P< 0.05 ).Conclusion CA,CAD,and the risk factors of CAD were closely correlated.CA by carotid ultrasound can be regarded as an independent risk factor in predicting cardiac event in patients with CAD.

关 键 词：动脉粥样硬化 冠状动脉 颈动脉 超声检查 心脏事件 

分 类 号：R541.4[医药卫生—心血管疾病] R540.4[医药卫生—内科学]