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[缺血性心脏病患者冠状动脉和颈动脉的结构与功能变化]

[Structural and functional changes of coronary and carotid arteries in patients with ischemic heart disease].

作者信息

Gaman S A, Balakhonova T V, Sinitsyn V E, At'kov O Iu, Ternovoĭ S K

出版信息

Ter Arkh. 2005;77(4):15-21.

Abstract

AIM

To assess prevalence of atherosclerotic changes in coronary arteries by computed tomography (CT) and carotid arteries by ultrasound duplex scanning (UDS) in patients with ischemic heart disease (IHD); to analyse viscoelastic properties of the walls of the common carotid arteries and their correlation with the results of carotid artery UDS and coronary artery CT.

MATERIAL AND METHODS

CT and UDS were made in 100 patients with clinically and coronarographycally verified diagnosis of IHD.

RESULTS

Calcinates in coronary arteries were found in 96% patients. The mean coronary calcium index (MCCI) was 544.8 +/- 718.5 units (from 0 to 3954 units). Atherosclerotic affection of carotid arteries was registered in 89% patients. Mean thickness of intima-media complex (IMT) of the common carotid arteries was 0.96 +/- 0.02 mm (0.60 mm - 1.87 mm). A correlation was found between coronary MCCI and IMT of the common carotid arteries. The stepwide regression analysis determined such predictors of coronary calcinosis as increased value of IMT of the common carotid arteries and atherosclerotic plaques (ASP) in carotid arteries. Viscoelasticity of the walls of the common carotid arteries in IHD patients differ from that of healthy subjects. This demonstrates stiffness of arterial wall in patients with IHD. There is a correlation between these parameters and IMT of the common carotid arteries.

CONCLUSION

Combination of UDS with CT in diagnosis of atherosclerotic lesions of different arteries provides more complete information about structural-functional changes in patients with IHD. Such non-invasive tests as measurement of IMT of common carotid arteries and detection of ASP in carotid arteries by UDS, determination of coronary MCCI may serve screening parameters in diagnosis of coronary atherosclerosis.

摘要

目的

通过计算机断层扫描(CT)评估缺血性心脏病(IHD)患者冠状动脉的动脉粥样硬化变化患病率,通过超声双功扫描(UDS)评估颈动脉的动脉粥样硬化变化患病率;分析颈总动脉壁的粘弹性特性及其与颈动脉UDS和冠状动脉CT结果的相关性。

材料与方法

对100例临床及冠状动脉造影确诊为IHD的患者进行CT和UDS检查。

结果

96%的患者冠状动脉发现钙化。平均冠状动脉钙化指数(MCCI)为544.8±718.5单位(范围为0至3954单位)。89%的患者颈动脉存在动脉粥样硬化病变。颈总动脉内膜中层复合体(IMT)的平均厚度为0.96±0.02毫米(0.60毫米至1.87毫米)。发现冠状动脉MCCI与颈总动脉IMT之间存在相关性。逐步回归分析确定颈总动脉IMT值增加和颈动脉粥样硬化斑块(ASP)是冠状动脉钙化的预测因素。IHD患者颈总动脉壁的粘弹性与健康受试者不同。这表明IHD患者动脉壁僵硬。这些参数与颈总动脉IMT之间存在相关性。

结论

UDS与CT联合用于诊断不同动脉的动脉粥样硬化病变,可为IHD患者的结构功能变化提供更完整的信息。诸如测量颈总动脉IMT、通过UDS检测颈动脉ASP以及测定冠状动脉MCCI等非侵入性检查可作为诊断冠状动脉粥样硬化的筛查参数。

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