颈脑一体化超声联合Hcy、hs-CRP对冠状动脉粥样硬化病变程度的评估

doi:10.7517/issn.1674-0475.221020

影像科学与光化学 ›› 2023, Vol. 41 ›› Issue (1): 96-101.DOI: 10.7517/issn.1674-0475.221020

颈脑一体化超声联合Hcy、hs-CRP对冠状动脉粥样硬化病变程度的评估

沈健¹, 张皓然², 王枫¹, 刘艳伟³, 李莎⁴, 杨绍石⁴

1. 承德医学院附属医院神经功能检查室, 河北承德 067000;
2. 承德医学院附属医院心脏内科, 河北承德 067000;
3. 承德医学院附属医院骨伤科, 河北承德 067000;
4. 承德医学院附属医院超声科, 河北承德 067000

收稿日期:2022-10-15 出版日期:2023-01-23 发布日期:2023-01-31
通讯作者: 沈健
基金资助:
河北省承德市科学技术研究与发展计划项目（202006A081）

Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP

SHEN Jian¹, ZHANG Haoran², WANG Feng¹, LIU Yanwei³, LI Sha⁴, YANG Shaoshi⁴

1. Neurological Examination Room, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei, P. R. China;
2. Department of Cardiology, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei, P. R. China;
3. Department of Orthopedics and Traumatology, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei, P. R. China;
4. Department of Ultrasound, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei, P. R. China

Received:2022-10-15 Online:2023-01-23 Published:2023-01-31

摘要/Abstract

摘要： 本研究探讨了颅内外血管颈脑一体化超声特征联合同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）评估冠状动脉粥样硬化病变程度的价值。选取疑似冠心病患者120例，经冠脉造影（CAG）确诊为冠心病的患者82例，包括冠脉轻度狭窄患者45例和中重度狭窄患者37例。患者均进行经颅多普勒超声和颈动脉血管超声检查，比较冠心病和非冠心病患者、不同冠脉病变程度患者的临床资料和超声参数差异，分析冠脉中重度狭窄的影响因素。结果表明，冠心病患者的Hcy、hs-CRP高于非冠心病患者（P<0.05）。中重度狭窄患者的年龄、总胆固醇（TC）、甘油三酯（TG）、Hcy、hs-CRP、颈动脉Crouse斑块积分和内膜中层厚度（IMT）高于轻度狭窄患者（P<0.05），而颅内动脉平均流速、收缩末期流速（PSV）和舒张末期流速（EDV）低于轻度狭窄患者（P<0.05）。颈动脉Crouse斑块积分、颈动脉IMT、Hcy和hs-CRP与Gensini评分呈正相关（P<0.05）。Logistic回归方程显示，Hcy、hs-CRP、颈动脉Crouse斑块积分、颈动脉IMT是冠心病患者冠脉中重度狭窄的影响因素（P<0.05），Logistic回归方程预测中重度狭窄的ROC曲线下面积为0.962（P<0.05）。颅内外血管颈脑一体化超声特征联合Hcy、hs-CRP评估预测冠状动脉粥样硬化病变程度有较好的效果。

关键词: 超声特征, 同型半胱氨酸, 超敏C反应蛋白, 冠状动脉粥样硬化病, 严重程度

Abstract: This study investigated the value of intracranial and extracranial integrated cervical cerebral ultrasound features combined with homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in evaluating the degree of coronary atherosclerosis. 120 patients with suspected coronary heart disease were selected, and 82 patients were diagnosed with coronary heart disease by coronary angiography (CAG), including 45 patients with mild coronary artery stenosis and 37 patients with moderate to severe coronary artery stenosis. All patients underwent transcranial Doppler ultrasound and carotid artery ultrasound examination, compared the differences in clinical data and ultrasound parameters between patients with coronary heart disease and without coronary heart disease, patients with different degrees of coronary artery disease, and analyzed the influencing factors of moderate to severe coronary artery stenosis. The results showed that the levels of Hcy and hs-CRP in CHD patients were higher than those in non-CHD patients (P<0.05). The age, total cholesterol (TC), triglyceride (TG), Hcy, hs-CRP, carotid Crouse plaque score and intima-media thickness (IMT) of patients with moderate to severe stenosis were higher than those of patients with mild stenosis (P<0.05), while the mean intracranial artery velocity, end-systolic velocity (PSV) and end-diastolic velocity (EDV) were lower than those of patients with mild stenosis (P<0.05). Carotid crouse plaque score, carotid IMT, Hcy and hs-CRP were positively correlated with Gensini score (P<0.05). The Logistic regression equation showed that Hcy, hs-CRP, carotid Crouse plaque score and carotid IMT were the influencing factors of moderate to severe coronary artery stenosis in patients with coronary heart disease (P<0.05). The area under the ROC curve of Logistic regression equation for predicting moderate to severe stenosis was 0.962 (P<0.05). The intracranial and extracranial integrated cervical cerebral ultrasound features combined with Hcy and hs-CRP have a good effect on evaluating and predicting the degree of coronary atherosclerosis.

Key words: ultrasonic characteristics, homocysteine, hypersensitive C-reactive protein, coronary atherosclerosis, severity

沈健, 张皓然, 王枫, 刘艳伟, 李莎, 杨绍石. 颈脑一体化超声联合Hcy、hs-CRP对冠状动脉粥样硬化病变程度的评估[J]. 影像科学与光化学, 2023, 41(1): 96-101.

SHEN Jian, ZHANG Haoran, WANG Feng, LIU Yanwei, LI Sha, YANG Shaoshi. Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 96-101.

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颈脑一体化超声联合Hcy、hs-CRP对冠状动脉粥样硬化病变程度的评估

Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP

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