e-Tracking技术评估不同冠脉狭窄程度与颈动脉弹性的相关性

摘要

Objective This article aims to evaluate the correlation between different coronary artery steno-sis severity and the carotid elasticity by using an e-Tracking technique. Methods A total of 180 patients who were suspected with coronary heart disease (CHD)and underwent coronary angiography (CAG)were in-cluded in this study.All the cases were divided into six groups according to the stenosis degree of coronary ar-teries on CAG:a non - stenosis group (group A),a mild - stenosis group (group B),a moderate stenosis group (group C),a severe stenosis group (group D)which were subdivided into groups D1,D2,D3 according to the number of diseased vessels.There were 30 cases in each group.Carotid elasticity parameters (Eρ、β、AC、AI、PWVβ)in the six groups measured by using the e-Tracking technique and carotid intima-media thickness (IMT)measured by using conventional two-dimensional ultrasound.All the available data were statistically analyzed. Results As the degree of coronary artery stenosis increased,IMT,Eρ,β,AI and PWVβvalues in-creased and AC values decreased,and the differences of the parameters in the overall comparison were statisti-cally significant.After excluding the confounding factors such as age,BMI,TC and so on,Eρandβwere the most sensitive parameters on detecting vascular elasticity,the comparison between groups showed statistically significant differences except between group D2 and D3.The second sensitive parameters on detecting vascular elasticity was AC,it meant vascular compliance was negatively associated with the degree of coronary artery stenosis,while the vascular stenosis reached to a certain degree (≥75%),there was no significant difference between single lesion and multi-vessel lesions.Comparison of IMT between group A and B,between group A and C,between group B and C yielded no statistical differences. Conclusion The more serious the coronary artery stenosis,the worse the carotid artery elasticity,there are high sensitivity of Eρ and β in assessing the correlation between coronary artery stenosis severity and the carotid elasticity,the variation of IMT is not sig-nificant when the coronary artery stenosis is not serious,and when multivessel coronary stenosis ≥ 75%,the difference of total carotid elasticity between 2 and≥3 vascular lesions is not significant.%目的：应用血管回声跟踪(e-Tracking)技术评估不同冠脉狭窄程度与颈动脉弹性的相关性。方法选择拟诊冠心病在我院行冠脉造影的患者180例,根据冠脉造影结果分为冠脉无狭窄组(A 组)、轻度狭窄组(B 组)、中度狭窄组(C 组)、重度狭窄组(D 组),D 组又根据病变血管数量分为 D1、D2、D3组,每组30例,应用常规二维超声测量颈动脉内膜中层厚度(IMT)和 e-Tracking 技术检测颈动脉弹性(Eρ、β、AC、AI、PWVβ),并进行统计学分析。结果随着冠脉狭窄程度的加深,IMT、Eρ、β、AI、PWVβ值升高而 AC 值降低,各参数总体比较差异均有统计学意义；排除年龄、BMI、TC 等混杂因素后,Eρ、β对血管弹性的检测最为敏感,除 D2和 D3组之外,各组之间比较差异均有统计学意义；其次是 AC,血管顺应性与冠脉狭窄程度呈反比,但当血管狭窄到一定程度时(≥75%),单支病变与多支病变间无统计学意义；IMT 在A 和 B 组、A 和 C 组、B 组和 C 组间比较差异均无统计学意义。结论冠脉狭窄越严重,颈动脉弹性受损越明显,其中Eρ、β在评估冠脉狭窄程度与颈动脉弹性相关性的敏感性较高,IMT 在冠脉狭窄程度较轻时变化不显著,当多支冠脉狭窄≥75%时,2支与≥3支血管病变中颈动脉总体弹性变化差异不大。