天津医药

• 论著 •    

心血管病高危人群颈动脉超声的临床应用

富华颖1,刘彤2,尹力3,郑成环4,李广平1,周长钰1   

  1. 1. 天津医科大学第二医院心脏科
    2. 医大二院心脏科
    3. 天津医大二院心内科
    4. 医大二院
  • 收稿日期:2009-10-29 修回日期:2010-04-29 出版日期:2010-08-15 发布日期:2010-08-15
  • 通讯作者: 李广平

Application of Carotid Arteries Ultrasound in High Cardiovascular Risk Patients.

  • Received:2009-10-29 Revised:2010-04-29 Published:2010-08-15 Online:2010-08-15

PDF (PC)

2111

摘要： 【摘要】 目的 观察心血管病高危人群颈动脉变化不同级别患者心血管病危险因素、临床心脑血管事件的发生数目以及冠状动脉病变程度。 方法 入选131例拟行冠状动脉造影术的心血管病高危患者，进行身高、体重、腰围、血压、心率测量，病史采集及血液生化检查。综合应用颈总动脉、分叉部或颈内动脉最大内中膜厚度(common carotid artery intima-media thickness,CCA-IMT)、颈总动脉、分叉部及颈内动脉颈动脉粥样硬化斑块的大小、长度将患者分为四组：1组颈动脉正常组(IMT≤1.0mm)；2组IMT增厚组(1.02）或弥漫性斑块（管腔内可见斑块长度≥2cm）组。结果：4组相比，随颈动脉病变的加重心血管危险因素数目增多 (分别为2.35±0.61；3.14±1.35；3.46±1.33；3.75±1.07，P<0.05)，心脑血管事件发生数目增多（0.00±0.00；0.29±0.47；0.46±0.66；0.58±0.65，P<0.05）。BMI 、TC、TG、 HDL 、LDL-c、BUN 、Cr、 Glu在4组间差异无统计学意义。病变分级高者收缩压较高(p<0.05)。在入选病例中，以颈动脉弥漫性斑块估测冠状动脉三支血管病变的敏感度为70.37%；特异度为96.77%。 结论：在心血管病高危人群中，随着颈动脉粥样斑块的出现和增多患者心脑血管事件发生率更高，心血管危险因素更多，血脂、血糖等因素因为这类人群认知程度的提高以及药物干预并无显著性差异。颈动脉多个或弥漫性斑块可能预测冠状动脉血管病变的程度。【关键词】颈动脉超声 心血管危险因素 心血管事件 冠状动脉粥样硬化

关键词: 颈动脉超声, 心血管危险因素, 心血管事件, 冠状动脉粥样硬化

Abstract: 【Abstract】 Objective To observe the relationship between carotid arteries ultrasound and cardiovascular risk factors,clinical cardiovascu1ar events as well as the degree of coronary artery disease in high cardiovascular risk patients.Methods Relevant clinical data, including height, weight, BMI, blood pressure, heart rate, history and blood biochemistry test were collected in 131consecutive patients with high cardiovascular risk and needed to be proformed selective coronary angiography(CAG). The patients were divided into 4 groups by Intima-media thickness(IMT) and degree of carotid plague through carotid arteries ultrasound exam. Plaque is defined as a focal structure that encroaches into the arterial lumen ,IMT value or demonstrates a thickness >1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. The number of risk factors and cardiovascular events in four groups were compared.Results Compared within four groups,the cardiovascular events and the number of cardiovascular risk factors were highest in the fourth group (0.00±0.00;0.29±0.47; 0.46±0.66;0.58±0.65; P<0.05and2.35±0.61;3.14±1.35;3.46±1.33;3.75±1.07P<0.05,respectively).Systolic blood pressure are significant difference in four groups. With diffused carotid artery plaque to predict three vessel coronary artery disease,the sensitivity and specificity is 70.37% and 96.77% respectively.Conclusions The patients with higher grade-level carotid artery plaque have high risk of cardiovascular diseases, and cerebrovascular events as wel as higher incidence of cardiovascular risk factors. Application of carotid artery ultrasound classification may be can predict coronary artery disease. 【Key words】carotid arteries ultrasound;cardiovascular risk factors;cardiovascular events;coronary atherosclerosis

Key words: carotid arteries ultrasound, cardiovascular risk factors, cardiovascular events, coronary atherosclerosis