冠心病患者颈动脉内膜-中层厚度及微量白蛋白尿与冠状动脉病变的关系

摘要

Objective To investigate the relationship of the carotid intima-media thickness and microalbuminuria with the severity of coronary artery lesions to the coronary heart disease. Methods 82 patients treated with coronary arteriography in our hospital from October 2009 to November 2011 were selected and divided into coronary artery imaging normal group (n=24), single-vessel disease group (n=22), double -vessel disease group (n=16) and three-multivessel disease group (n=20). Gensini method was used to calculate the integral of coronary artery lesion degree; carotid artery sonography were applied before and 1 week after the coronary arteriography, bilateral carotid IMT and plaque situation were checked up: microalbuminuria value was measured, the relationship of the carotid IMT and microalbuminuria with the severity of coronary artery lesions were analyzed. Results IMT of single-vessel disease group, double -vessel disease group and three-multivessel disease group were all higher than those of coronary artery imaging normal group; carotid TMT, plaque occurrence rate, plaque integral and microalbuminuria were all found increased followed the severity of the coronary artery lesion, the differences were all statistically significant (all P ＜ 0.05). Positive relationship was found between the microalbuminuria and Gensin-S (r=0.54,P ＜ 0.05), positive relationship was found between the microalbuminuria and IMT (r = 0.57,P ＜ 0.05). Conclusion Carotid TMT and microalbuminuria can predict the severity of coronary artery lesions and have important clinical significant of evaluate the coronary heart disease.%目的 探讨冠心病患者冠状动脉病变程度与颈动脉内膜-中层厚度(IMT)及尿微量白蛋白(MAU)的相关性.方法 选择2009年10月～2011年11月我院行冠状动脉造影者82例,根据血管病变程度分为冠状动脉造影正常组(n = 24)、单支病变组(n = 22)、双支病变组(n = 16)、三支及多支病变组(n = 20),Gensini法计算冠状动脉病变程度积分;在冠状动脉造影前及冠状动脉造影后1周进行颈动脉超声,检查患者双侧颈动脉IMT及斑块情况,同时测定MAU,分析冠心病病变程度和颈动脉粥样硬化及MAU水平的相关性.结果 与冠状动脉正常组比较,单支病变组、双支病变组和三支及多支病变组的颈总动脉IMT明显增厚,而且随着冠状动脉病变程度的加重,其颈动脉IMT、斑块发生率、斑块积分及MAU亦随之增加,差异均有统计学意义(均P < 0.05).MAU与Gensin-S呈正相关(r = 0.54,P < 0.05),与颈动脉IMT亦呈正相关(r = 0.57,P < 0.05).结论 颈动脉IMT及MAU水平同冠状动脉病变程度具有相关性,通过测定颈动脉IMT及MAU含量可预测冠状动脉的病变程度.