Hulthe J, Wikstrand J, Emanuelsson H, Wiklund O, de Feyter P J, Wendelhag I
Wallenberg Laboratory for Cardiovascular Research, Gothenburg, Sweden.
Stroke. 1997 Jun;28(6):1189-94. doi: 10.1161/01.str.28.6.1189.
Ultrasound is increasingly used to measure atherosclerotic development in carotid and femoral arteries. The aim of this study was to investigate the relationship between coronary atherosclerosis as measured by quantitative angiography and peripheral atherosclerosis as measured by ultrasound in three different arterial regions.
Patients (n = 32) with at least two coronary segments with visible signs of atherosclerosis as defined in a computer-assisted analysis of coronary angiograms were also examined with B-mode ultrasound. The extent of coronary atherosclerosis was expressed as the average diameter stenosis of coronary segments, and peripheral atherosclerosis was defined as intima-media thickness (IMT) and plaque occurrence in the common carotid artery, the carotid bulb, and the common femoral artery.
The results showed a significant correlation between the ultrasound measurement of IMT of the carotid bulb and diameter stenosis of the included coronary segments (r = .68, P = .01) and of carotid plaques and diameter stenosis (P < .001). The correlation between common carotid IMT and diameter stenosis of included coronary segments was not statistically significant (r = .31, NS). There were no significant relationships between common femoral IMT or femoral plaques and diameter stenosis of included coronary segments.
Although this study is small, it points to a very important aspect of ultrasound measurements of atherosclerosis: measurements performed in the common carotid artery or the femoral artery may not relate to coronary atherosclerosis in the same way as measurements performed in the carotid bulb. The findings underline the importance of measuring IMT not only in the common carotid artery but also in the carotid bulb and present data separately. These results have to be confirmed in a larger-scale study.
超声越来越多地用于测量颈动脉和股动脉的动脉粥样硬化发展情况。本研究的目的是探讨通过定量血管造影测量的冠状动脉粥样硬化与通过超声测量的三个不同动脉区域的外周动脉粥样硬化之间的关系。
对至少有两个冠状动脉节段出现动脉粥样硬化可见迹象(在冠状动脉造影的计算机辅助分析中定义)的患者(n = 32)进行B型超声检查。冠状动脉粥样硬化的程度用冠状动脉节段的平均直径狭窄来表示,外周动脉粥样硬化定义为颈总动脉、颈动脉球部和股总动脉的内膜中层厚度(IMT)和斑块发生率。
结果显示,颈动脉球部IMT的超声测量值与所纳入冠状动脉节段的直径狭窄之间存在显著相关性(r = 0.68,P = 0.01),颈动脉斑块与直径狭窄之间也存在显著相关性(P < 0.001)。颈总动脉IMT与所纳入冠状动脉节段直径狭窄之间的相关性无统计学意义(r = 0.31,无显著性差异)。股总动脉IMT或股动脉斑块与所纳入冠状动脉节段直径狭窄之间无显著关系。
尽管本研究规模较小,但它指出了动脉粥样硬化超声测量的一个非常重要的方面:在颈总动脉或股动脉进行的测量与冠状动脉粥样硬化的关系可能与在颈动脉球部进行的测量不同。这些发现强调了不仅要在颈总动脉测量IMT,还要在颈动脉球部测量并分别呈现数据的重要性。这些结果必须在更大规模的研究中得到证实。