CAJ | 학술논문

目的探讨颈总动脉内-中膜厚度(IMT)、内-中膜横切面面积(IMCSA)对冠心病的预测价值.方法根据冠状动脉造影结果将81例行冠状动脉检查者分为冠心病组(51例)和对照组(30例),再根据受累冠状动脉数量将冠心病组分为一支病变组(10例)、二支病变组(22例)及三支病变组(19例).超声测定所有病例双侧颈总动脉IMT、IMCSA,并进行分析.结果冠心病组左侧颈总动脉IMT为(0.92±0.15)mm,IMCSA为(22.0±2.8)mm~2,而对照组左侧颈总动脉IMT为(0.85±0.07)mm,IMCSA为(18.4±2.1)mm~2,两组左侧颈总动脉IMT及IMCSA比较,差异均有统计学意义(P<0.05);而两组右侧颈总动脉IMT、IMCSA比较,差异无统计学意义(P>0.05).随着冠状动脉病变支数的增加,双侧颈总动脉斑块发生率亦增加(P<0.01).以左侧颈总动脉IMT≥0.90 mm预测冠心病的敏感度为64.7%,特异度为66.7%;以左侧颈总动脉IMCSA≥20 mm~2预测冠心病的敏感度为80.4%,特异度为86.7%.结论颈总动脉斑块的检出,同时结合左侧颈总动脉IMT及IMCSA,尤其是IMCSA,可以作为预测冠心病的指标及是否进行冠状动脉造影的筛选方法.
목적 탐토경총동맥내-중막후도(IMT)、내-중막횡절면면적(IMCSA)대관심병적예측개치.방법 근거관상동맥조영결과장81례행관상동맥검사자분위관심병조(51례)화대조조(30례),재근거수루관상동맥수량장관심병조분위일지병변조(10례)、이지병변조(22례)급삼지병변조(19례).초성측정소유병례쌍측경총동맥IMT、IMCSA,병진행분석.결과 관심병조좌측경총동맥IMT위(0.92±0.15)mm,IMCSA위(22.0±2.8)mm~2,이대조조좌측경총동맥IMT위(0.85±0.07)mm,IMCSA위(18.4±2.1)mm~2,량조좌측경총동맥IMT급IMCSA비교,차이균유통계학의의(P<0.05);이량조우측경총동맥IMT、IMCSA비교,차이무통계학의의(P>0.05).수착관상동맥병변지수적증가,쌍측경총동맥반괴발생솔역증가(P<0.01).이좌측경총동맥IMT≥0.90 mm예측관심병적민감도위64.7%,특이도위66.7%;이좌측경총동맥IMCSA≥20 mm~2예측관심병적민감도위80.4%,특이도위86.7%.결론 경총동맥반괴적검출,동시결합좌측경총동맥IMT급IMCSA,우기시IMCSA,가이작위예측관심병적지표급시부진행관상동맥조영적사선방법.
Objective To explore the relationship of carotid Intima-media thickness and cross-sectional area to coronary diseases (CD).Methods Eighty-one subjects receiving CD examination were divided,according to the results of coronary angiography,into groups CD (n=51) and control (n=30),and group CD subdivided,based on the number of involved coronary arteries,into groups 1-(n=10),2-(n=22),3-artery (n=19).Bilateral common carotid artery IMT,IMCSA were measured by ultrasound and analyzed in all cases.Results ITM,IMCSA of left common carotid artery were 0.92±0.15 mm,22.0±2.8 mm~2,respectively,in CD group and 0.85±0.07 mm,18.4±2.1 mm~2,respectively,in control groups,the difference was significant (P<0.05).The incidence of bilateral common carotid artery plaque rose with the increase in number of injured coronary arteries (P<0.01).Taking left common carotid artery IMT≥0.90 mm as the border,the sensitivity and specificity of predicting CHD were 64.7%,66.7%,respectively,and taking IMCSA≥20 mm~2 as the border,were 80.4%,86.7%,respectively.Conclusion Detection of common carotid artery plaque,combined with left common carotid artery IMT and IMCSA(especially IMCSA),can be used as indicators for prediction of CHD and a screening method deciding whether coronary angiography is needed.