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1、周圍血管動脈粥樣硬化與冠狀動脈粥樣硬化相關(guān)性的研究【摘要】目的應(yīng)用超聲方法檢測外周動脈內(nèi)-中膜厚度(IMT)及斑塊情況,探討外周動脈與冠狀動脈粥樣硬化的相關(guān)性,評價(jià)超聲檢測外周動脈粥樣硬化對冠狀動脈病變的預(yù)測價(jià)值及其臨床意義。方法對110例天津醫(yī)科大學(xué)第二醫(yī)院心臟科住院行冠狀動脈造影(CAG)的患者術(shù)后1~2周內(nèi),行外周動脈(包括頸總、頸內(nèi)、頸外、股總、股淺、股深、腘、足背動脈)粥樣硬化情況進(jìn)行超聲檢查,以動脈IMT和粥樣硬化斑塊厚度作為觀測指標(biāo),對各組病例外周動脈粥樣硬化的情況進(jìn)行比較,進(jìn)行統(tǒng)計(jì)學(xué)分析,探討動脈粥樣硬化發(fā)生的危
2、險(xiǎn)因素,外周動脈與冠狀動脈粥樣硬化的相關(guān)性。結(jié)果(1)CCAIMT、頸動脈IMT、CFAIMT、SFAIMT、DFAIMT、下肢動脈IMT在冠脈未見異常組與其余三組任一組均差異有統(tǒng)計(jì)學(xué)意義(P<0.05),冠脈未見異常組IMT值小于其余三組。(2)隨著冠狀動脈粥樣硬化血管的數(shù)量增加,頸動脈和下肢動脈動脈粥樣硬化情況加重,斑塊形成呈明顯增加趨勢。(3)多因素Logistic回歸分析(STEPWISE),CFAIMT和P下肢與冠狀動脈粥樣硬化具有顯著相關(guān)性,有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論(1)頸動脈、下肢動脈和冠狀動脈粥樣硬化的
3、趨勢一致。(2)頸部和下肢血管的IMT及斑塊對冠狀動脈粥樣硬化有很好的預(yù)測價(jià)值;P下肢、CFAIMT可作為預(yù)測冠狀動脈粥樣硬化的重要指標(biāo)。(3)年齡、吸煙時(shí)間、患有高血壓及高血壓患病時(shí)間、甘油三酯、空腹血糖、胰島素水平是動脈粥樣硬化的高危因素。13【關(guān)鍵詞】動脈粥樣硬化;外周動脈;超聲;冠狀動脈造影[Abstract]ObjectiveExaminingperipheralarterieswithultrasoundanddescribingtheextentofatherosclerosiswithIMTandplaque,t
4、oinvestigatethecorrelationofperipheralarteriesatherosclerosisandcoronaryarteryatherosclerosis,evaluatethepredictingvalueofperipheralarterieswithultrasoundtocoronaryarteryatherosclerosisandclinicalvalue.MethodsOnehundredandtenpatientswereexaminedbyultrasoundaftercoron
5、aryangiographyof1~2weeks,observingtheintima-mediathicknessandplaqueconditionofcommoncarotidartery,internalcarotidartery,externalcarotidartery,carotidbifurcation,commonfemoralartery,superficialfemoralartery,deepfemoralartery,poplitealartery,dorsalispedisartery,measuri
6、ngandrecordingIMT,thicknessoftheatheroscleroticplaque,andstenosisextentofdifferentarteries.Accordingtocoronaryangiography,allpatientswereclassifiedintofourgroups.Contrastingtheatheroscleroticpathologyoffourgroups,tostudytheriskfactorsofatherosclerosis,thecorrelationo
7、fperipheralarteryatherosclerosisandcoronaryarteryatherosclerosis.Results13(1)StatisticalsignificancesofCCAIMT,carotidarteryIMT,CFAIMT,SFAIMT,DFAIMT,lowerlimbsarteriesIMTwereinferredatP<0.05betweenthegroupwithnormalcoronaryarteriesandanyoneoftheleftthreegroups,andtheI
8、MTofthegroupwithnormalcoronaryarterieswaslessthanothergroups.(2)Withthenumberofatheroscleroticcoronaryarteriesincreasing,theatheros