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目的 :探讨冠心病 (CHD)患者颈动脉内中膜厚度 (IMT)及粥样斑块的发生情况 ,及其对CHD的诊断价值。方法 :据冠状动脉造影将 76例患者分为CHD组 (5 2例 )和非CHD组 (2 4例 ) ,分别进行颈动脉超声检查 ,应用受试者工作特征 (ROC)曲线评价颈总动脉IMT ,以冠状动脉造影作为金标准 ,计算IMT及粥样斑块诊断CHD的灵敏性、特异性。结果 :非CHD组及CHD组IMT分别为 (0 .79± 0 .11)及 (1.11± 0 .37)mm ,斑块发生率分别为 8.3% (2 / 2 4 )及 71.2 % (37/ 5 2 ) ,两组间比较均差异有统计学意义 (P <0 .0 1)。颈总动脉IMT诊断CHD的ROC曲线下面积 (AUC)为 0 .80 ,IMT诊断CHD的最佳分界值为 0 .90mm ,以IMT≥ 0 .90mm及 (或 )出现粥样斑块来预测CHD ,敏感性 82 .7% ,特异性 79.2 %。结论 :颈总动脉IMT对诊断CHD有一定的准确性 ,IMT≥ 0 .90mm及 (或 )出现粥样斑块是预测CHD较为敏感的指标。
Objective: To investigate the incidence of carotid intima-media thickness (IMT) and plaque in patients with coronary heart disease (CHD) and its diagnostic value for CHD. Methods: According to coronary angiography, 76 patients were divided into two groups: CHD group (52 cases) and non-CHD group (24 cases). Carotid ultrasonography was performed respectively. The common carotid artery IMT, coronary angiography as the gold standard, calculate the IMT and plaque diagnosis of CHD sensitivity, specificity. Results: The IMT of non-CHD group and CHD group were (0.79 ± 0.11) and (1.11 ± 0.37) mm, respectively. The plaque incidence rates were 8.3% (2/24) and 71.2% 5 2). There was significant difference between the two groups (P <0.01). The area under the ROC curve (AUC) of carotid artery IMT in diagnosing CHD was 0.80, the best cutoff value of IMD in diagnosing CHD was 0.90mm, and the incidence of CHD was predicted by IMT≥0.90mm and / or atheroma , Sensitivity 82.7%, specificity 79.2%. Conclusion: The common carotid artery IMT has a certain accuracy in the diagnosis of CHD. IMT≥0.90mm and / or atherosclerotic plaque is a predictor of CHD.