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背景: 以往的研究显示随着冠状动脉严重程度的增加, 颈动脉狭窄的发生率和严重程度也增加。与白种人比较, 中国脑卒中的患者以颅内的小动脉病变居多而颅外颈动脉病变相对少见。目的: 观察存在冠状动脉 3 支病变患者的颈动脉和颅内动脉受累情况。设计: 观察性实验。单位: 首都医科大学附属北京朝阳医院神经内科; 首都医科大学附属北京朝阳医院心脏中心。对象: 选择 2003- 08/2004- 08 于首都医科大学附属北京朝阳医院神经内科门诊就诊和住院的疑诊为冠状动脉硬化性心脏病的患者行冠状动脉造影, 对其中发现 3 支病变的 126 例患者同时进行颈动脉造影检查。其中男 56 例, 女 70 例; 年龄 47～76 岁。纳入对象均对检测项目知情同意。方法: 126 例患者行冠状动脉造影后即刻行动脉数字减影血管造影。常规应用 Seldinger 技术穿刺股动脉插管, 多角度投照, 同时观察双侧颈动脉, 锁骨下动脉和椎动脉。面积狭窄百分比由数字减影血管造影机图像后处理站直接计算获取。根据颈动脉造影结果为判定标准将患者分为正常、轻度狭窄、中度狭窄、重度狭窄和颈动脉闭塞。主要观察指标: 患者颈动脉的狭窄程度。结果: 纳入的 126 例冠状动脉硬化性心脏病患者全部进入结果分析。颈动脉轻度、中度、重度和闭塞的患者比例相当, 分别为 13 (10.32%), 18(14.29%), 12 (9.50%), 和 10 (7.90%)。冠状动脉 3 支病变合并颈动脉异常的比例为 42.06%。结论: 中国人群中冠状动脉 3 支病变同时合并颈动脉狭窄的发生率与西方人同样很高。冠状动脉 3 支病变的人群中, 颈动脉狭窄的发生率高于颅内动脉。冠状动脉 3 支病变的人应该接受颈动脉的造影检查。
Background: Previous studies have shown an increased incidence and severity of carotid stenosis as the severity of coronary arteries increases. Compared with Caucasians, stroke patients in China mostly intracranial arteriolar lesions and extracranial carotid lesions relatively rare. Objective: To observe the involvement of carotid and intracranial arteries in 3 patients with coronary artery lesions. Design: Observational experiments. SETTING: Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University; Beijing Chaoyang Hospital Cardiac Center, Capital Medical University. PARTICIPANTS: Coronary angiography was performed on patients suspected of having coronary heart disease from the Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University from 2003 to August 2004, and 126 cases of 3 lesions were found Patients underwent carotid angiography at the same time. There were 56 males and 70 females, aged 47-76 years. Subjects involved in the informed consent of the test items. Methods: One hundred and sixty-six patients underwent digital subtraction angiography immediately after coronary angiography. Commonly used Seldinger technology femoral artery puncture, projection from multiple angles, while observing bilateral carotid artery, subclavian artery and vertebral artery. A narrow percentage of area is obtained directly from the digital subtraction angiography machine image post-processing station. According to the result of carotid angiography, the patients were divided into normal, mild stenosis, moderate stenosis, severe stenosis and carotid artery occlusion. MAIN OUTCOME MEASURES: Carotid stenosis in patients. Results: All 126 patients with coronary artery disease were involved in the result analysis. The proportions of patients with mild, moderate, severe and occluded carotid artery were comparable, accounting for 13 (10.32%), 18 (14.29%), 12 (9.50%), and 10 (7.90%), respectively. Coronary artery disease with 3 carotid artery anomalies accounted for 42.06%. Conclusion: The prevalence of simultaneous carotid artery stenosis in 3 coronary artery lesions in Chinese population is as high as that in Westerners. Coronary artery disease in 3 patients, the incidence of carotid stenosis higher than intracranial artery. 3 patients with coronary artery disease should be accepted carotid angiography.