摘要
目的探讨联合颈动脉和大脑中动脉超声检查预测冠状动脉(下称冠脉)病变的临床意义。方法选择2017年8月至2021年1月嘉兴市第二医院收治的89例冠心病患者为观察组,另择同期本院89名健康体检者作对照组,比较两组对象颈动脉内中膜厚度(IMT)、斑块种类、斑块类型、斑块半定量评分、大脑中动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值血流速度(PSV)、舒张期速度(D),比较观察组中度和重度冠脉狭窄患者IMT、斑块半定量评分、PI、RI、PSV、D,采用多因素logistic回归分析、ROC曲线对数据进行统计分析。结果观察组患者IMT、斑块种类≥2种患者占比,不均质斑块和软斑块患者占比,斑块半定量评分,PI及RI高于对照组,差异均有统计学意义(均P<0.01)。观察组冠脉重度狭窄患者IMT、斑块半定量评分、PI、RI高于中度患者,差异均有统计学意义(均P<0.01)。多因素logistic回归分析显示,IMT、斑块半定量评分、PI、RI均是冠心病发病的影响因素(均P<0.01)。IMT、斑块半定量评分、PI、RI联合预测冠心病的AUC为0.918,大于各指标单独预测值。结论颈动脉和大脑中动脉动脉超声检查均异常者应作冠脉病变筛选检查。
Objective To investigate clinical significance of combined carotid artery and middle cerebral artery ultrasonic examination for predicting coronary artery disease(CAD).Methods A total of 89 patients with CAD(observation group)admitted to the Second Hospital of Jiaxing from August 2017 to January 2021 and 89 healthy subjects underwent physical examination(control group)at the same time were included.The carotid intimal thickness(IMT),plaque type,semi-quantitative score of plaque,middle cerebral artery pulsatility index(PI),resistance index(RI),peak systolic blood flow velocity(PSV),and diastolic velocity(DV)were compared between the two groups.The IMT,semi-quantitative score,PI,RI,PSV,DV were compared between patients with moderate and with severe coronary stenosis.Multivariate logistic regression analysis and ROC curve were used to analyze the data.Results IMT,the proportion of patients with plaque types≥2,with heterogeneous plaques and soft plaques,semi-quantitative score,PI and RI were significantly higher in the observation group than in the control group(all P<0.01).IMT,semi-quantitative score,PI,and RI were significantly higher in patient with severe coronary stenosis than with moderate coronary stenosis(all P<0.01).Multivariate logistic regression analysis showed that IMT,semi-quantitative score,PI and RI were influence factors of CAD(all P<0.01).ROC showed that the AUC of a combination of IMT,semi-quantitative score,PI and RI in predicting CAD was 0.918,which was higher than that of each parameter.Conclusion Patients with abnormal ultrasound measurements of both carotid artery and middle cerebral artery should receive examination for CAD screening.
作者
刘成玮
孙伟奇
马旦杰
俞晓华
沈嘉
杨成梁
朱长玉
LIU Chengwei;SUN Weiqi;MA Danjie;YU Xiaohua;SHEN Jia;YANG Chengliang;ZHU Changyu(Department of Ultrasound,Jiaxing Second Hospital,Jiaxing 314000,China)
出处
《心电与循环》
2023年第6期536-540,545,共6页
Journal of Electrocardiology and Circulation
关键词
超声参数
颈动脉
大脑中动脉
冠脉狭窄
冠心病
Ultrasound parameters
Carotid artery
Middle cerebral artery
Coronary stenosis
Coronary heart disease
