【摘要】 目的探讨冠心病患者颈动脉粥样硬化情况和肱动脉内皮依赖性舒张功能的变化以及外周血管超声预测冠心病的临床价值。方法采用高分辨率超声测定132例受试者颈动脉内中膜厚度和斑块积分及肱动脉内皮依赖性舒张功能。结果冠心病组颈动脉内中膜厚度明显大于对照组[(0.87±0.16)mmvs(0.72±0.13)mm,P<0.01]。冠心病组斑块发生率明显高于对照组。冠心病多支病变组mIMTc较单支病变组明显增厚[(0.99±0.17)mmvs(0.85±0.15)mm,P<0.01],其斑块积分也较单支病变组高。在93例接受冠脉造影检查的患者中,有47例阳性的冠心病患者以mIMTc≥0.85mm预测冠心病的有无,其敏感性为72.3%,特异性为76.1%,总符合率74.2%(69/93)。冠心病患者肱动脉内皮依赖性舒张功能明显低于对照组[(6.21±1.92)%vs(9.04±3.03)%,P<0.01],132例受试者颈动脉内中膜厚度与肱动脉内皮依赖性舒张功能呈负相关,而在冠心病患者中两者无相关性。结论颈动脉粥样硬化程度可间接反映冠状动脉病变的程度。冠心病患者存在肱动脉内皮依赖性舒张功能的受损和颈动脉內中膜厚度的增厚。更多还原

【Abstract】 Objective To investigate the carotid atherosclerosis(the intima-media thickness on carotid artery and plaques)and the brachial artery flow-mediated dilation(FMD)in patients with coronary heart disease(CHD)and evaluate the relation between CHD and carotid atherosclerosis.Methods Intima-media thickness(IMT)and plaques in the carotid arteries were assessed with high-resolution B-mode ultrasonography and the brachial artery FMD were measured in 86 patients with coronary heart disease and 46 healthy control subjects.Results The intima-media thickness of coronary heart disease group was significantly thicker than that of the control group [(0.87±0.16)mm vs(0.72±0.13)mm,P<0.01].The prevanlence rates of plaques were 77.9% and 17.4%,Carotid atherosclerosis was more prevalent in CHD patients as compared with control.The mIMTc of multivessel group was significantly thicker than that of single vessel group[(0.99±0.17)mm vs(0.85±0.15)mm,P<0.01] and significant differences of carotid plaque score were found between the single vessel group and the multivessel subjects [(1.60±1.27 vs 2.68 ±1.82),P<0.05].An mIMTc≥0.85mm could predict the presence of coronary heart disease with a specifity of 75%,a sensitivity of 72.3%.The FMD in CHD patients was significantly impaired when compared with those in control group [(6.21±1.92)% vs(9.04±3.03)%,P<0.01].FMD was inversely correlated with mIMTc in 132 subjects(r=-0.497,P<0.01),but there was no significant correlation between FMD and mIMTc in the patients with coronary heart disease(r=-0.163,P>0.05).Conclutions The CHD patients often accompanied with carotid and vasodilation dysfunction.There are close relationship between carotid and coronary artery atherosclerosis.Carotid ultrasound examination could help to predict the presence of coronary artery disease.更多还原