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目的探讨颈动脉超声对预测冠状动脉狭窄患者颅内动脉狭窄的价值,以及颈动脉超声相对于其它动脉粥样硬化主要危险因素预测缺血性心脑血管疾病的优越性。方法对209例经血管造影证实冠状动脉狭窄(≥70%)的患者采用彩色多谱勒血流成像(CDFI)和经颅多普勒超声(TCD)分别检查颈动脉和颅内动脉,并将患者分为颈动脉狭窄组与非狭窄组;脑动脉狭窄组与非狭窄组,分别比较狭窄组与非狭窄组之间的危险因素及生化指标,进一步对冠状动脉狭窄合并颅内动脉狭窄的主要危险因素与颈动脉超声结果中具有显著性统计学意义的指标,分析二者之间的相关性。结果颈动脉超声对缺血性心脑血管疾病的预测价值较传统的危险因素更高。结论高血压病、颈动脉球部内膜增厚、多发斑块及不均质回声斑块对冠状动脉狭窄患者颅内动脉狭窄有明显的促进作用。采用CDFI对确诊冠状动脉狭窄患者进行检测,对心脑血管事件高危人群进行筛选、评价治疗疗效和预后具有重要意义。
Objective To investigate the value of carotid artery ultrasound in predicting intracranial arterial stenosis in patients with coronary artery stenosis and the superiority of carotid artery ultrasound in predicting ischemic cardiovascular and cerebrovascular diseases compared with other major risk factors of atherosclerosis. Methods 209 carotid and intracranial arteries were examined by color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) in 209 patients with coronary artery stenosis (≥70%) confirmed by angiography. Patients were divided into carotid stenosis group and non-stenosis group; cerebral artery stenosis group and non-stenosis group, the risk factors and biochemical indexes were compared between stenosis group and non-stenosis group, and further to coronary stenosis with intracranial arterial stenosis Risk factors and carotid ultrasound results were statistically significant indicators, analysis of the correlation between the two. Results The predictive value of carotid ultrasonography for ischemic cardiovascular disease was higher than the traditional risk factors. Conclusions Hypertension, thickening of the intima of carotid bulb, multiple plaques and heterogeneous echogenic plaques have significant effects on intracranial artery stenosis in patients with coronary artery stenosis. The use of CDFI in the diagnosis of patients with coronary artery stenosis, screening for high risk groups of cardiovascular and cerebrovascular events screening, evaluation of treatment efficacy and prognosis of great significance.