目的研究冠心病患者冠心病颈动脉斑块及血hs-CRP、D-dimer水平的相关性。方法收集临床诊断冠心病患者80例,非冠心病对照组30例。冠心病组又分为急性心肌梗死、不稳定性心绞痛、稳定性心绞痛三个亚组。超声探测各组颈动脉IMT、Crouse积分;并检测血浆hsCRP、D-dimer水平;所得数据进行统计分析。结果①冠心病组IMT、Crouse积分、hsCRP、D-dimer浓度均高于对照组,差异有统计学意义(P<0.01)。②冠心病组三个亚组中IMT,Crouse积分差别无统计学意义(P>0.05)。SAP组、UAP组、AMⅠ组的hsCRP水平依次升高,差别具有统计学意义(P<0.05);与SAP组比,UAP组、AMⅠ组患者血D-dimer浓度显著升高,有显著差异(P<0.05);与UAP组比较,AMⅠ组hsCRP明显高于UAP组(P<0.05),D-dimer无显著性差异(P>0.05)。③经直线相关分析,D-dimer、hsCRP浓度分别与IMT及Grouse积分呈正相关;血浆D-dimer同时与hs-CRP有较好的相关性,相关系数为r=0.682,(P<0.05)。结论颈动脉超声检查,有助于识别冠心病高危患者。hsCRP、D-dimer是反映斑块的稳定性的可靠指标。颈动脉超声结合hsCRP、D-dimer检测,对冠心病患者不同缺血状态有一定的诊断价值。 Objective To study the correlation between carotid plaque, blood hs-CRP and D-dimer levels in patients with coronary heart disease. Methods Eighty patients with clinical diagnosis of coronary heart disease and 30 patients with non-coronary heart disease were collected. Coronary heart disease group is divided into acute myocardial infarction, unstable angina, stable angina three subgroups. Ultrasound detection of carotid IMT, Crouse integral; and detection of plasma hsCRP, D-dimer levels; the data were statistically analyzed. Results ① The concentrations of IMT, Crouse, hsCRP and D-dimer in CHD group were significantly higher than those in control group (P <0.01). ② There was no significant difference in IMT and Crouse scores among the three subgroups of coronary heart disease (P> 0.05). The levels of hsCRP in SAP group, UAP group and AMⅠ group were significantly higher than those in SAP group (P <0.05). The levels of D-dimer in UAP group and AMⅠ group were significantly higher than those in SAP group (P <0.05) (P <0.05). Compared with UAP group, hsCRP in AMⅠgroup was significantly higher than that in UAP group (P <0.05) and D-dimer had no significant difference (P> 0.05). ③The linear correlation analysis showed that the concentrations of D-dimer and hsCRP were positively correlated with IMT and Grouse scores, respectively. The plasma D-dimer also had a good correlation with hs-CRP at the same time, the correlation coefficient was r = 0.682 (P <0.05). Conclusion Carotid ultrasonography can help identify high-risk patients with coronary heart disease. hsCRP, D-dimer is a reliable indicator of plaque stability. Carotid ultrasound combined with hsCRP, D-dimer test for patients with different ischemic coronary heart disease have a certain diagnostic value.