Study On Relationship Between Peripheral Atherosclerotic Lesions And Coronary Artery Lesions

【Objective】Explore the association between peripheral atherosclerotic lesions and coronary artery lesions to provide a measure which is more reliable to diagnose Coronary Heart Disease at the early stage,and can help provide accurate risk stratification,develop an appropriate treatment plan and determine prognosis.【Methods】The experimental group concluded 63 patients who were indentifined Coronary Heart Disease through selective coronary angiography or coronary artery CT.Then the experimental group was divided into single vessel disease group,two vessel disease group and triple vessel disease group according to the extent of coronary artery involvement.Meanwhile we measured the Ankle-brachial index(ABI),abtained the Intima-media thickness(IMT) and atherosclerotic plaque through ultrasound testing,and got the creatinine clearance rate(Ccr) and urinary microalbumin(MA) of each patient.Another 48 cases without Coronary Heart Disease were incorporated into the control group,and also did the peripheral atherosclerotic lesions-related detection.At last,we compared the difference of peripheral atherosclerotic indexs between experimental group and control group,and analysed the relationship between peripheral atherosclerotic index and coronary artery disease. 【Results】1.The reference range of ABI is 1.00～1.30,and the decreasing thresold value in this study is ABI≤0.90.We found ABI in control group is 1.08±0.10,2 cases decreased(the abnormal incidence rate was 4.17%);ABI in experimental group is 1.08±1.18,11 cases decreased(17.46%).Among the experimental group,ABI in single vessel disease group was 1.02±0.19 and 6 cases decreased(3.75%);ABI in two vessel disease group was 1.10±0.16 and 3 cases decreased(14.29%);ABI in triple vessel disease group was 1.09±0.18 and 2 cases decreased(7.69%).There was no significant difference between each two groups(P＞0.05).2.The reference range of IMT is 0.40～1.00mm,and the increasing thresold value in this study is IMT≥1.00mm.We found IMT in control group is 0.88±0.15mm,7 cases increased(the abnormal incidence rate was 14.58%) and 3 cases were detected atherosclerotic plaque(6.25%);IMT in experimental group is 1.27±0.31mm,55 cases increased(87.30%) and 39 cases were detected atherosclerotic plaque(61.90%). Among the experimental group,IMT in single vessel disease group was 1.18±0.31mm, 12 cases increased(75.00%) and 11 cases were detected atherosclerotic plaque (68.75%);IMT in two vessel disease group was 1.23±0.22mm,20 cases increased (95.24%) and 12 cases were detected atheroscterotic plaque(57.14%);IMT in triple vessel disease group was 1.36±0.35mm,23 cases increased(88.46%) and and 16 cases were detected atherosclerotic plaque(61.54%).There was significant difference between control group and experimental group(P＜0.05).Both the IMT value and the incidence rate of plaque in experimental group is higher than those in control group. And there was no significant difference among 3 groups belonged to experimental group(P＞0.05).3.The reference range of Ccr is 80～120ml/min/1.73m~2,and the decreasing thresold value in this study is Ccr＜60ml/min/1.73m~2,We found Ccr in control group is 92.09±21.86ml/min/1.73m~2,1 case decreased(the abnormal incidence rate was 2.08%);Ccr in experimental group is 92.09±21.86 ml/min/1.73m~2,13 cases decreased(20.63%).Among the experimental group,Ccr in single vessel disease group was 76.86±+18.44ml/min/1.73m~2 and 2 cases decreased(12.50%);Ccr in two vessel disease group was 82.98±24.58 ml/min/1.73 m~2 and 1 case decreased(4.76%); Ccr in triple vessel disease group was 0.39±31.58 ml/min/1.73m~2 and 10 cases decreased(38.46%).There was significant difference between control group and experimental group(P＜0.05).Ccr in single vessel disease group and triple vessel disease group was lower than control group;but there was no significant difference among 3 groups belonged to experimental group(P＞0.05).4.The reference range of MA is≤30μg/ml,and the increasing thresold value in this study is MA＞30μg/ml.We found MA in control group is 12.50±11.63μg/ml,4 cases increased(8.33%);MA in experimental group is 23.05±19.45μg/ml,16 cases increased(25.40%).Among the experimental group,MA in single vessel disease group was 14.02±13.49μg/ml and 1 cases increased(6.25%);MA in two vessel disease group was 18.95±15.21μg/ml and 3 case increased(14.29%);MA in triple vessel disease group was 31.91±22.27μg/ml and 12 cases increased(46.15%).There was significant difference between control group and experimental group(P＜0.05).MA in triple vessel disease group was higher than control group.There was no significant difference between single vessel disease group and two vessel disease group,but MA in both the two groups was higher than MA in triple vessel disease group.5.Logistic regression analysis showed that Coronary Artery Disease is significantly associated with IMT(odds ratio[OR]396.746,95%confidence interval [CI]17.501～8.994E3),plaque(OR 2.253,95%CI 0.806～6.294),and Ccr(OR 0.972, 95%CI 0.948～0.996).【Conclusion】1.Among the population without Coronary Heart Disease,the incidence rate of peripheral atherosclerotic lesions is lower(29.17%).Carotid artery is mainly affected, followed by kidney,and limb arteries are least affected.2.Among the population with Coronary Heart Disease,the incidence rate of peripheral atherosclerotic lesions is higher(92.60%).Carotid artery is mainly affected, followed by kidne and limb arteries. 3.Coronary artery lesions is significantly associated with peripheral atherosclerotic lesions,mainly the intima-media thickness and atherosclerotic palques of carotid artery,followed by creatinine clearance rate.But ankle-brachial index and urinary microalbumin are not clearly related to coronary artery lesions.4.The intima-media thickness and atherosclerotic palques of carotid artery and creatinine clearance rate could be used as better reference indicators which are reliable to diagnose Coronary Heart Disease at early stage,and can help provide accurate risk stratification,develop an appropriate treatment plan and determine prognosis.