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目的探讨颈动脉的内膜-中层厚度(Intima-media Thickness,IMT)、肱动脉内皮舒张功能与冠心病(Coronary Artery Disease,CAD)的相关性及临床意义。方法对159例冠脉造影受检者应用彩色高频超声探查肱动脉于静息状态下、反应性充血之后以及于口腔黏膜下含服硝酸甘油之后舒张末期内径的变化并对颈动脉的IMT进行测定,同时观察颈动脉粥样硬化斑块的数量。结果 CAD单支病变组与多支病变组的IMT增厚以及斑块发生率均显著高于对照组(P<0.01),反应性充血诱发的肱动脉内径扩张百分率均低于对照组(P<0.01);多支病变组颈动脉的IMT以及斑块发生率均与单支病变组之间有明显差异(P<0.05),反应性充血诱发的肱动脉内径扩张百分率均低于单支病变组(P<0.05);多支病变组和单支病变组组间及两组与对照组间含硝酸甘油后的肱动脉内径扩张百分率均无明显差异。结论通过超声检查观察颈动脉粥样硬化病变程度及肱动脉内皮舒张功能改变可间接反映冠状动脉病变的情况。
Objective To investigate the correlation and clinical significance of carotid intima-media thickness (IMT), brachial artery endothelial function and coronary artery disease (CAD). Methods 159 cases of coronary angiography by color high-frequency ultrasound probe brachial artery at rest, after reactive hyperemia and sublingual nitroglycerin in the oral end-diastolic diameter changes and the carotid IMT were measured , While observing the number of carotid atherosclerotic plaque. Results IMT thickening and plaque incidence were significantly higher in CAD group and multivessel disease group than those in control group (P <0.01). The percentage of dilatation of brachial artery induced by reactive hyperemia was lower than that in control group (P < 0.01). The carotid IMT and plaque incidence in multi-vessel disease group were significantly different from that in single vessel disease group (P <0.05), and the percentage of brachial artery diameter expansion induced by reactive hyperemia was lower than that in single vessel disease group (P <0.05). There was no significant difference in the percentage of dilatation of brachial artery between groups with multi-vessel disease and those with single vessel disease or between two groups and control group. Conclusion Ultrasound examination of carotid atherosclerosis lesions and brachial artery endothelial function can indirectly reflect the change of coronary artery lesions.