Objective To evaluate the relationship between carotid plaque neovascularization and coronary heart disease using contrast-enhanced ultrasound. Methods We studied carotid plaques in 312 patients with coronary artery disease by contrast-enhanced ultrasound [51 patients with acute coronary syndrome (ACS) and 261 patients with stable coronary artery disease (sCAD) ]. We analyzed sonographic features of each plaque, including the enhancement intensity of plaque (A value), the ratio of plaque to carotid artery lumen in enhancement intensity (Ratio), plaque thickness and plaque echo (soft plaque, hard plaque, mixed plaque, calcified plaque). Results The average thickness of plaque in patients with ACS and in patients with sCAD had no significant difference in statistics [(2.6±0.4) mm vs (2.9±0.8) mm, t=-1.903, P=0.058) ]. The group with ACS:soft plaque 43 (84.3%, 43/51), mixed plaque 8 (15.7%,8/51), no hard plaque and calcified plaque. And the group with sCAD:soft plaque 174 (66.7%,174/261), hard plaque 19 (7.3%,19/261), mixed plaques 16 (6.1%,16/261), calcified plaque 52 (19.9%,52/261). The percentage of soft plaque in the acute coronary syndrome group was significantly higher than that in stable coronary artery disease group (χ2=6.274,P=0.012). The A value and Ratio in patients with ACS were prominently larger than those in patients with sCAD [ (11.3±3.2) vs (8.9±3.3) dB, t=7.150,P<0.01;0.6±0.2 vs 0.4±0.2, t=7.419,P<0.01].Conclusion Carotid artery plaque neovascularization density was significantly higher in patients with ACS than that in patients with sCAD by using contrast-enhanced ultrasound, revealing that the neovascularization density is closely related to clinical symptoms of patients with coronary heart disease.%目的评价颈动脉粥样硬化斑块的新生血管与冠状动脉粥样硬化性心脏病（简称冠心病）的关系。方法312例冠心病患者中急性冠状动脉综合征（ACS）患者51例（ACS组），稳定性冠心病（sCAD）患者261例（sCAD组）。采用超声造影技术检测2组患者的颈动脉斑块。供分析的超声声像图参数包括：斑块造影增强强度（A值）、斑块增强强度与颈动脉管腔内增强强度比值、斑块厚度、斑块回声的特点（软斑块、硬斑块、钙化斑块、混合斑块）。结果 ACS组患者斑块厚度平均为（2.6±0.4）mm，sCAD组患者斑块厚度平均为（2.9±0.8）mm，2组患者斑块厚度间差异无统计学意义（t=-1.903，P=0.058）。ACS组43例（84.3%，43/51）为软斑块，8例（15.7%，8/51）为混合斑块，无硬斑块和钙化斑块；sCAD组174例（66.7%，174/261）为软斑块，19例（7.3%，19/261）为硬斑块，16例（6.1%，16/261）为钙化斑块，52例（19.9%，52/261）为混合斑块。ACS组患者软斑块所占比例高于sCAD组，差异有统计学意义（χ2=6.274，P=0.012）。ACS组患者斑块增强强度及其比值分别为（11.3±3.2）dB和0.6±0.2，sCAD组患者斑块增强强度及其比值分别为（8.9±3.3）dB和0.4±0.2，2组比较，差异均有统计学意义（t=7.150、7.419，P均＜0.01）。结论超声造影检查可发现急性冠状动脉综合征患者颈动脉斑块新生血管密度显著高于稳定性冠心病患者，揭示颈动脉斑块新生血管密度与冠心病患者的临床症状紧密相关。
展开▼
