摘要
目的 应用超声造影观察冠状动脉粥样硬化性心脏病（冠心病）患者颈动脉斑块内新生血管的显像特征，探讨斑块内新生血管与血脂水平的关系。方法 选取2012年12月至2016年12月于北京市中关村医院常规超声检查显示颈动脉粥样硬化斑块形成且斑块最大厚度≥2.0 mm的患者118例，其中冠心病患者59例（冠心病组），非冠心病者59例（对照组）。2组均行超声造影检查，分析2组斑块形成情况、超声造影增强率、斑块达峰时间、最大峰值强度比、曲线下面积，同时测定三酰甘油、总胆固醇、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇水平。结果 冠心病组共检出193个斑块，对照组共检出164个斑块。冠心病组软斑发生率、超声造影增强率明显高于对照组［50.8%（98/193）比31.7%（52/164）、73.1%（141/193）比43.9%（72/164）］（P＜0.05）。冠心病组斑块达峰时间短于、最大峰值强度比高于、曲线下面积大于对照组［（16.8±1.9）s比（19.0±2.4）s、（68±7）%比（59±7）%、（2 498±403）dB/s比（1 985±396）dB/s］（P＜0.01）。冠心病组三酰甘油及LDL-C水平明显高于对照组［（2.2±1.1）mmol/L比（1.5±0.8）mmol/L、（3.1±0.8）mmol/L比（2.2±0.8）mmol/L］（P＜0.05）。结论 颈动脉粥样硬化斑块中新生血管密度增高，可能是冠心病的危险因素。临床可选择超声造影联合血脂检测作为冠心病的筛选和随访手段。
Objective To observe neovascularization of carotid plaques in patients with coronary atherosclerotic heart disease（CHD） by contrast-enhanced ultrasound and to analyze the relation between neovascularization and blood lipid level. Methods Totally 118 patients with carotid atherosclerotic plaques（the highest thickness≥2.0 mm） in Zhongguancun Hospital, Chinese Academy of Sciences were enrolled from December 2012 to December 2016; 59 patients had CHD（CHD group）; 59 patients without CHD were enrolled as control group. All patients had contrast-enhanced ultrasound examination; plaques formation, ultrasound enhancement rate, peak time of plaque, maximum peak intensity ratio and area under the curve were measured. Levels of triacylglycerol, total cholesterol, low density lipoprotein cholesterol（LDL-C） and high density lipoprotein cholesterol were tested. Results One hundred and ninety-three plaques were detected in CHD Group; 164 plaques were detected in control group. The soft plaque rate and ultrasound enhancement rate in CHD group were significantly higher than those in control group[50.8%（98/193） vs 31.7%（52/164）, 73.1%（141/193） vs 43.9%（72/164）]（P〈0.05）. Peak time of plaque in CHD group was significantly shorter, maximum peak intensity ratio and area under the curve were higher than those in control group[（16.8±1.9）s vs （19.0±2.4）s,（68±7）% vs （59±7）%,（2 498±403）dB/s vs （1 985±396）dB/s]（P〈0.01）. Levels of triacylglycerol and LDL-C in CHD group were significantly higher than those in control group[（2.2±1.1）mmol/L vs （1.5±0.8）mmol/L,（3.1±0.8）mmol/L vs （2.2±0.8）mmol/L]（P〈0.05）. Conclusion High density of neovascularization in carotid atherosclerotic plaques analyzed by contrast-enhanced ultrasound may be a risk factor of CHD.
作者
赵君
潘明康
张凤秀
张宇
陈玲丽
Zhao Jun Pan Mingkang Zhang Fengxiu Zhang Yu Chen Lingli(Department of Ultrasonography, Beijing Zhongguancun Hospital, Beijing 100190, China)
出处
《中国医药》
2017年第7期975-977,共3页
China Medicine
基金
北京市科技计划（Z141100002114040）
关键词
冠状动脉疾病
颈动脉粥样硬化
超声造影
Coronary artery disease
Carotid atherosclerosis
Contrast-enhanced ultrasound
