Geng B, Cao T, Duan Y
Department of Ultrasound, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China.
Zhonghua Yi Xue Za Zhi. 2001 Jun 10;81(11):651-4.
To investigate the diagnostic value of peripheral artery ultrasonography for coronary atherosclerotic disease (CAD).
Peripheral artery ultrasonography was conducted among 135 consecutive examinees of coronary arteriography before the CAG. The results of peripheral artery ultrasonography and of coronary arteriography were analyzed with Stepwise multiple regression analysis and Logistic regression.
The incidence of atherosclerotic plaques of carotid, subclavicular, abdominal aortic, iliac and femoral arteries in patients with positive coronary arteriography was significantly higher than that in the subjects with negative coronary arteriography (P < 0.01); Logistic regression indicated that the presence of atherosclerotic plaques in femoral, abdominal aortic, and common iliac arteries was significantly closely correlated with CAD (P < 0.005, < 0.01, and < 0.05 respectively). Stepwise multiple regression analysis showed that common iliac IMT and femoral IMT were significant closely associated with the severity of coronary atherosclerosis (P < 0.0001). For each increased 1mm of iliac and femoral IMT, the LOG (1 + Gensini's score) of coronary arteriography increased by 0.227 and 0.219 respectively. The carotid artery IMT was partly associated with the LOG (1 + Gensini's score) of coronary arteriography (P < 0.05). The total score of extracoronary atherosclerosis (TSEcAS) was significantly correlated with the occurrence and severity of CAD (P < 0.0001). For 1 more extracoronary atherosclerotic plaques, the odds ratio and LOG (1 + Gensini's scores) for CAD increased 4.98 times and 0.323 respectively. Common iliac atherosclerosis was closely correlated with the occurrence of acute myocardial infarction. The positive predictive value of femoral, iliac atherosclerosis is 87.9%, 86.7%, 80.0% respectively; the positive predictive value for 2 and 3 sites of 3 above sites and is 88.6% and 94.9% respectively. Accuracy of discriminative function for positive and negative results and total was 91.5%, 93.8% and 92.5% respectively.
EcAS is closely correlated with CAD. It is possible to predict the occurrence, development, extent and severity of coronary artery atherosclerosis by extracoronary atherosclerosis. Common iliac atherosclerosis and femoral atherosclerosis are two independent factors closely correlated with the occurrence and progression of coronary atherosclerosis and can be used as the alternative indicators in study of coronary atherosclerosis.
探讨外周动脉超声检查对冠状动脉粥样硬化性心脏病（CAD）的诊断价值。
对135例连续接受冠状动脉造影（CAG）检查的受检者在CAG前进行外周动脉超声检查。采用逐步多元回归分析和Logistic回归分析外周动脉超声检查结果与冠状动脉造影结果。
冠状动脉造影阳性患者的颈动脉、锁骨下动脉、腹主动脉、髂动脉和股动脉粥样硬化斑块发生率显著高于冠状动脉造影阴性者（P<0.01）；Logistic回归分析表明，股动脉、腹主动脉和髂总动脉粥样硬化斑块的存在与CAD显著密切相关（分别为P<0.005、<0.01和<0.05）。逐步多元回归分析显示，髂总动脉内膜中层厚度（IMT）和股动脉IMT与冠状动脉粥样硬化严重程度显著密切相关（P<0.0001）。髂动脉和股动脉IMT每增加1mm，冠状动脉造影的LOG(1+Gensini积分)分别增加0.227和0.219。颈动脉IMT与冠状动脉造影的LOG(1+Gensini积分)部分相关（P<0.05）。冠状动脉外动脉粥样硬化总分（TSEcAS）与CAD的发生及严重程度显著相关（P<0.0001）。冠状动脉外每多一个粥样硬化斑块，CAD的比值比及LOG(1+Gensini积分)分别增加4.98倍和0.323。髂总动脉粥样硬化与急性心肌梗死的发生密切相关。股动脉、髂动脉粥样硬化的阳性预测值分别为87.9%、86.7%、80.0%；上述3个部位中2个及3个部位阳性的预测值分别为88.6%和94.9%。判别阳性和阴性结果及总体的判别功能准确性分别为91.5%、93.8%和92.5%。
冠状动脉外动脉粥样硬化（EcAS）与CAD密切相关。通过冠状动脉外动脉粥样硬化有可能预测冠状动脉粥样硬化的发生、发展、范围及严重程度。髂总动脉粥样硬化和股动脉粥样硬化是与冠状动脉粥样硬化的发生和进展密切相关的两个独立因素，可作为冠状动脉粥样硬化研究中的替代指标。
