冠心病患者冠状动脉粥样硬化程度与颈动脉粥样硬化的相关性研究

目的 探讨冠心病患者颈动脉粥样硬化与冠状动脉硬化程度之间的关系.方法 选取2012年1月至2013年6月河北大学附属医院心内科治疗的冠心病患者350例,依据冠状动脉造影结果将患者分为冠心病组和非冠心病组,其中冠心病组260例,非冠心病组90例;依据造影结果将冠心病组患者进行再次分组,其中单支病变组113例,双支病变组89例,三支病变组58例.比较冠心病组及非冠心病组间及不同冠状动脉病变支数三组间的颈动脉内-中膜厚度（IMT）、斑块积分及Gensini评分;统计分析冠状动脉病变支数与以上观察指标的相关性.结果 冠心病组的颈动脉IMT、斑块积分、Gensini积分分别为（1.37±0.23）、（5.37±3.98）、（23.32±7.33）,均高于非冠心病组,两组间比较差异有统计学意义（P＜0.05）.双支病变组和三支病变组的斑块检出率为79.8％和81.0％,双支病变组及三支病变组患者颈动脉IMT分别为（1.31±0.21）mm和（1.37±0.27）mm,双支病变组和三支病变组患者的斑块检出率与颈动脉IMT值均高于单支病变组,三组间比较差异有统计学意义（P＜0.05）.冠状动脉病变支数与IMT、颈动脉斑块积分呈显著正相关;Gensini评分与IMT及颈动脉斑块积分呈显著正相关.结论 冠状动脉的粥样硬化程度随着患者的颈动脉粥样硬化程度的升高而加重,冠心病的严重程度可以通过颈动脉超声检测反映出来.

Correlation of carotid atherosclerosis and coronary atherosclerosis in patients with coronary heart disease

Objective To explore the correlation of carotid atherosclerosis and coronary atherosclerosis in patients with coronary heart disease. Methods 350 patients with coronary heart disease admitted to Hebei University Hospital heart medicine were selected from January 2012 to June 2012, and on the basis of the results of coronary angiography patients were divided into CHD group （n=260 cases） and non CHD group （n=90 cases）. Again according to the results of imaging, the group of patients with coronary heart disease group, including single lesion group 113 examples, double branch lesion group 89 examples, three lesion group of 58 cases. The count of IMT, plaque integral and Gensini score were compared between CHD group and non CHD group and among the three groups of coronary artery lesion; coronary artery lesion counts and the relationship with the above observation index were analyzed. Results Compared with non CHD group, carotid IMT, plaque integral and Gensini score in CHD group were （1.37±0.23）, （3.98±5.37）, （23.32±7.33）respectively, were higher than in the CHD group, the com- parison between the two groups was statistically difference （P〈0.05）. Compared with single lesion group, double branch lesion group and three lesions in patients with plaque detection rate was 79.8% and 81.0%, the IMT of carotid artery in double lesions group and three lesions was （1.31±0.21）and （1.37±1.37）, double branch lesions and the three lesions of groups of patients with carotid artery plaque detection rate IMT values were higher than in single lesion group （P〈0.05）. Coronary artery lesion counts were significantly positively related with IMT and carotid plaque score. Gensini score was significantly positively related with IMT and carotid plaque score. Conclusion The degree of coronary atherosclerosis is related with the severity of carotid atherosclerosis, and thus the ultrasound detection of carotid atherosclerosis may reflect the degree of coronary heart disease.