超声对主动脉瓣钙化与颈动脉粥样硬化关系的探讨

初洪钢; 苏丽华; 郭瑞强; 孙彬; 姜霞; 孙有刚

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中国临床医学影像杂志 ›› 2007, Vol. 18 ›› Issue (8) : 544-547.

论著

超声对主动脉瓣钙化与颈动脉粥样硬化关系的探讨

初洪钢1，苏丽华2，郭瑞强1，孙彬1，姜霞1，孙有刚1

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Correlation between aortic valve calcification and carotid atherosclerotic disease through ultrasound

CHU Hong-gang1, SU Li-hua2, GUO Rui-qiang1, SUN Bin1, JIANG Xia1, SUN You-gang1

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摘要

目的：探讨主动脉瓣钙化（AVC）与颈动脉粥样硬化之间的关系，明确AVC能否作为颈动脉粥样硬化的独立预测因子。方法：采用高频超声方法对214例AVC患者及182例年龄、性别与之相匹配的无AVC对照者的颈动脉进行了检测。结果：①与对照组比较，AVC组患者收缩压和舒张压均高于对照组（P<0.01）；②AVC组患者颈总动脉及颈内动脉IMT明显增厚（P<0.05）；③AVC组颈动脉粥样硬化斑块检出率明显高于对照组（44.39％对18.13％，P＝0.000）；④AVC组颈动脉狭窄程度≥20%、≥40%、≥60%及双侧颈动脉狭窄程度≥20%、≥40%、≥60%的发生率均显著高于对照组（P<0.01～0.05）；AVC组无颈动脉狭窄的发生率明显低于对照组（21.50％对42.86％，P=0.000）；⑤AVC组患者颈总动脉和颈内动脉的Vm明显低于对照组（P<0.01），PI（P<0.01）和RI（P<0.01）明显高于对照组；⑥多因素Logistic回归分析结果表明：AVC是颈动脉狭窄≥40%惟一有意义的预测因子（P=0.004）。结论：AVC与颈动脉粥样硬化之间存在十分密切的关系，通过对AVC的检测，能够预测颈动脉粥样硬化的存在及其程度，在临床实际工作中，对于有AVC的患者应常规进行颈动脉粥样硬化的检查。

Abstract

Objective: To determine whether there is an association between the presence of aortic valve calcification(AVC) and carotid artery atherosclerotic disease. Methods: 214 patients with AVC diagnosed by transthoracic echocardiography underwent carotid artery ultrasound at the same time. They were compared with 182 age- and sex-matched persons without AVC who underwent carotid artery ultrasound during the same period. Results: ①Compared with the control group, the AVC group showed a significantly higher prevalence of systolic blood pressure(SBP) and diastolic blood pressure(DBP)[(162±18)mmHg versus (120±14)mmHg, P<0.01; (101±16)mmHg versus (78±12)mmHg, P<0.01). ②IMTs of CCA and ICA in the AVC group were significantly thicker than that in the control group[(1.17±0.18)mm versus (0.90±0.10)mm, P=0.000; (1.06±0.18)mm versus (0.81±0.12)mm, P=0.000, respectively].③Compared with the control group, the AVC group showed a significantly higher prevalence of carotid atherosclerotic plaque(44.39% versus 18.13%, P=0.000). ④The AVC group showed a significantly higher prevalence of carotid stenosis ≥20%(78.50% versus 57.14%, P=0.000), ≥40%(36.45% versus 22.53%, P=0.003), ≥60%(15.42% versus 8.24%, P=0.029), and ≥20%(38.32% versus 22.53%, P=0.001), ≥40%(19.63% versus 9.89%, P=0.007), ≥60%(7.01% versus 1.10%, P=0.004) of bilateral carotid artery. ⑤Vm of CCA and ICA in the AVC group were decreased significantly than that in the control group[(30.26±7.83)cm/s versus (41.25±8.32)cm/s, P=0.000; (35.46±6.85)cm/s versus (47.36±11.35)cm/s, P=0.000]. But PI(1.64±0.48 versus 1.35±0.32, P=0.010; 0.96±0.28 versus 0.85±0.16, P=0.039) and RI(0.78±0.07 versus 0.65±0.06, P=0.000; 0.81±0.11 versus 0.60±0.05, P=0.000) of CCA and ICA in the AVC group were increased significantly than that in the control group. ⑥On multivariate analysis, AVC was the only independent predictor of carotid atherosclerotic disease(stenosis of ≥40%, P=0.004). Conclusions: There is a significant association between the presence of AVC and carotid artery atherosclerotic disease. AVC may be an important marker for atherosclerotic disease of the carotid arteries. Carotid artery high frequency ultrasound should be underwent to the patients with AVC diagnosed by transthoracic echocardiography as a common.

导出引用

初洪钢;苏丽华;郭瑞强;孙彬;姜霞;孙有刚. 超声对主动脉瓣钙化与颈动脉粥样硬化关系的探讨[J]. 中国临床医学影像杂志. 2007, 18(8): 544-547

CHU Hong-gang;SU Li-hua;GUO Rui-qiang;SUN Bin;JIANG Xia;SUN You-gang. Correlation between aortic valve calcification and carotid atherosclerotic disease through ultrasound[J]. Journal of China Clinic Medical Imaging. 2007, 18(8): 544-547

中图分类号： Ｒ542.52 Ｒ543.5 Ｒ445.1