冠心病患者颈动脉超声检查的特征

摘要

目的:观察冠心病患者的颈动脉超声检查的特征,探索冠心病病情严重程度与颈动脉超声检查的关系.方法:选择在心内科同期住院的102例冠心病患者,其中心肌梗死(MD患者37例,非MI患者65例,另选58例非冠心病患者作为正常对照组.测定颈动脉超声图像,血流动力学指标,血脂、血糖等生化指标,并进行统计学分析.结果:颈动脉超声显示,颈动脉内膜中层厚度在冠心病非MI组[(0.99±0.18)mm],MI组[(0.99±0.22)mm]明显大于正常对照组[(0.78±0.11)mm],P<0.05,颈总动脉最大流速冠心病非MI组[(71.34±19.76)cm/s],MI组[(78.92±20.61)cm/s]明显高于正常对照组[(67.38±14.35)cm/s],P<0.05.冠心病非MI组斑块发生率为69.2%,MI组为62.2%,明显高于正常对照组(36.2%,P均<0.01).Pearson相关分析显示颈动脉内膜中层厚度与总胆固醇、低密度脂蛋白-胆固醇、甘油三酯水平呈显著正相关(标准化回归系数0.460～0.862,P均<0.001).结论:颈动脉超声不仅可间接评价冠心病患者,且颈动脉内膜中层的厚度与血脂异常显著相关.%Objectives To observe characteristics of carotid artery ultrasonogram in patients with coronary heart disease (CHD) and explore the relationship between carotid artery ultrasonogram and severity of CHD. Methods: A total of 102 CHD patients admitted in our department were enrolled) including 37 cases with myocardial infarction (MI group) and 65 non—MI cases (CHD non—MI group). Another 58 non —CHD patients were enrolled as normal control group. Carotid artery ultrasonogram, hemodynamic indexes, and biochemical indexes such as blood lipid and blood glucose of the patients were measured and statistically analyzed. Results: Carotid artery ultrasonogram indicated that carotid intima-media thickness of CHD non— MI group [ (0. 99±0. 18) mm] and MI group [ (0. 99±0. 22) mm] significantly increased compared with that of control group [ (0. 78±0. 11) mm], P＜0. 05. Carotid artery peak velocities of CHD non—MI group [ (71. 34±19. 76) cm/s] and MI group [ (78. 92±20. 61) cm/s] were significantly higher than that of control group [ (67. 38±14. 35) cm/s], P＜0. 05. Incidence rates of carotid plaque of CHD non—MI group (69.2％) and MI group (62.2％) were significantly higher than that of control group (36.2％, P＜0. 01 both). Pearson correlation analysis indicated that carotid intima-media thickness is positively correlated with levels of total cholesterd, low density lipoprotein-chdsterd and triglyceride (standardized regression coefficient 0. 460～0. 862, P＜0. 001 all). Conclusion; Carotid artery ultrasonography could indirectly evaluate coronary heart disease. Carotid inti-ma-media thickness is significantly correlated with dyslipidemia.