超声颈动脉内中膜厚度与斑块诊断冠状动脉粥样 硬化性心脏病的价值对比

Comparison of the values of ultrasound carotid intima-media thickness and plaque in the diagnosis of coronary heart disease

摘要:

目的 探讨与对比超声颈动脉内中膜厚度（IMT）与斑块诊断冠状动脉粥样硬化性心脏病（以 下简称冠心病）的价值。方法 采用回顾性与便利抽签研究方法，选取2016 年2 月—2018 年2 月在海南 省人民医院诊治的120 例冠心病患者作为观察组，选取同期该院120 例健康体检者作为对照组，记录两组 一般资料、检验指标与超声颈动脉IMT、斑块特点。结果 两组年龄、体重指数、性别、高密度脂蛋白 胆固醇、低密度脂蛋白胆固醇及甘油三酯比较，差异无统计学意义（P >0.05）；观察组血糖、总胆固醇 （TC）高于对照组（P <0.05）。观察组颈动脉IMT 厚度、斑块发生率高于对照组（P <0.05）。Logistic 回归 分析显示，TC、血糖及血管病变数目为影响冠心病颈动脉IMT 的危险因素（P <0.05）。选择诊断临界点 为IMT=0.90 mm，此时敏感性、特异性、准确性分别为75.0%、87.5% 和78.9%（P >0.05）；选择颈动脉斑块 作为临界值，敏感性与特异性、准确性分别为71.2%、91.7% 和77.6%（P >0.05）。结论 超声颈动脉IMT、 斑块可全面反映冠心病的发生与病情，可作为反映冠心病的窗口，对提高冠心病的诊断效果具有重要临床 意义。

Abstract:

Objective To discuss and compare the values of ultrasound carotid intima-media thickness (IMT) and plaque in the diagnosis of coronary heart disease (CAD). Methods Using a retrospective study and convenience method, From February 2016 to February 2018, 120 patients with coronary heart disease were selected as the observation group, and the other healthy people in hospital health examination were selected as the control group at the same period. Two groups were enrolled in the general information, test index and ultrasound carotid artery IMT, plaque characteristics. Results There were no significant difference in the age, body mass index, sex, TC, HDL-C and LDL-C compared between the two groups (P > 0.05).The blood glucose and TG in the observation group were significantly higher than those in the control group (P < 0.05). The thinkness and the incidence of carotid artery IMT and plaque in control group were significantly higher than that of control group (P < 0.05). Logistic regression analysis showed that TG, blood glucose and the number of vascular lesions were the main factors influencing the carotid artery IMT in coronary heart disease (P < 0.05). When the critical point of diagnosis were IMT = 0.90 mm, the sensitivity, specificity and accuracy were 75.0%, 87.5% and 78.9%, respectively (P > 0.05). When the carotid plaques were selected as critical values, the sensitivity, specificity and accuracy were 71.2%, 91.7% and 77.6%, respectively (P > 0.05). Conclusions Carotid artery IMT and plaque can reflect the occurrence and condition of coronary heart disease. It can serve as windows to reflect coronary heart disease and have important clinical significance in improving the diagnostic effect of coronary heart disease.