| Objective: To detect carotid artery intima-media by color Doppler ultrasound and to measure radial flow related parameters by pulsed Doppler ultrasound and to probe predictive value of carotid artery film thickness as well as plaque and radial artery systole peak value blood flow velocity, End-diastolic blood flow velocity resistance index, pulsatility index and contraction early peak time and constriction prophase peak acceleration for coronary heart disease,to find an early non-invasive,economical,simple clinical way to predict coronary heart disease.Methods:171patients were collected with suspected coronary artery disease who had selective coronary angiography in First Affiliated Hospital of Henan University of Technology from 2009.11to 2010.6. Routine heart color doppler examination preoperative,heart function EF≥50% to be selected; Adopted the Dutch Philips company's5500 color Doppler ultrasound ;High frequency linear frequency of 7.0-10MHz probe to exam Bilateral carotid artery and record carotid intima-media thickness; whether plaques; All the patients were divided the carotid intima-media normal group and thickening group. Choosed high-frequency probe(frequency 4.0-10MHz) to measure radial diameter and blood flow spectrum.By instrument built-in function,recorded radial artery peak systolic velocity(PSV), end diastolic velocity(EDV), resistive index(RI) ,pulsitile index(PI)and peak acceleration time(AT) , and calculated systolic peak acceleration Va=PSV/AT. According to coronary angiography result, the patients were divided coronary positive group and coronary negative group and coronary positive group was divided single lesion group, two lesions group and three lesions group.Result: In 171 patients,there were 116patients in the tunica media of carotid artery thickend group and 55 patients in the normal group, There were significant differences in EDV PI RI AT Va of radial artery between the tunica media of carotid artery thickend group and the normal group (p<0.05), while no significant difference in PSV between two groups. There were 41 coronary angiography(-) patients and 130 coronary angiography(+) patients in 171 patients. There were significant differences in EDV, RI of radial artery between the coronary angiography(-) group and the coronary angiography(+) group. while no significant difference in PSV, PI, AT, Va between two groups. Further analysis showed, there were no significant differences in PSV of radial artery among the coronary angiography(-) group, single coronary arterial lesion group, two coronary arterial lesion group and three coronary arterial lesion group(p>0.05). there were no significant differences in EDV between the coronary angiography(-) group and single coronary arterial lesion group, two coronary arterial lesion group and three coronary arterial lesion group and among single coronary arterial lesion group, two coronary arterial lesion group and three coronary arterial lesion group(p>0.05), while significant difference between the coronary angiography(-) group and two coronary arterial lesion group, the coronary angiography(-) group and three coronary arterial lesion group(p<0.05). PI was significant difference between two coronary arterial lesion group and three coronary arterial lesion group (p<0.05). while the rest is not significant difference each other(p>0.05). RI of radial artery was significant difference between the coronary angiography(-) group and single coronary arterial lesion group, the coronary angiography(-) group and two coronary arterial lesion group, the coronary angiography(-) group and three coronary arterial lesion group(p<0.05),while no significant difference among single coronary arterial lesion group, two coronary arterial lesion group and three coronary arterial lesion group. AT and Va were not significant difference each other.ITM thickend patients (13 patients) in the coronary angiography(-) group were significantly less than who (103 patients) in the coronary angiography(+) group(p<0.05). The rate of carotid artery plaques in the coronary angiography(+) group was 63.8% and in the coronary angiography(-) group was 29.3%, there was significant different between the two groups(p<0.05). there was no significant different in IMT among the coronary angiography(-) group, single coronary arterial lesion group and two coronary arterial lesion group, among single coronary arterial lesion group, two coronary arterial lesion group and there coronaryarterial lesion group(p>0.05), while significant differencet between single coronary arterial lesion group and there coronary arterial lesion group(p<0.01). It is more and more important value of predicting coronary heart disease following ITM,s thicking. Age analysis showed, there was no significant differentt in age among the coronary angiography(-) group, single coronary arterial lesion group and two coronary arterial lesion group,between single coronary arterial lesion group and two coronary arterial lesion group, between two coronary arterial lesion group and there coronary arterial lesion group(p>0.05), while significant different between coronary angiography(-) group and there coronary arterial lesion group(p<0.05). The incidence of coronary heart disease increased with the rising of patients age,and the severity of coronary heart disease was significantly correlated with the number of coronary arterial lesion.the internal diameter of the right radial artery was not significant different among the coronary angiography(-) group, single coronary arterial lesion group, two coronary arterial lesion group and there coronary arterial lesion group(p>0.05).Conclusion:1.Carotid atherosclerosis patients, diastolic blood flow velocity RI and PI of right radial decrease, increased arterial stiffness, elastic function drops, cause shrinkage early peak acceleration time extends,acceleration decreased.2. Carotid intima-media lesions, the more serious the coronary artery lesions, the counts the predictive value.3. It is valuable for coronary artery disease prediction of the right's EDV and RI.4. With increasing age, the incidence of coronary disease was higher, and carotid intima-media thickness and plaques incidence were higher, right radial artery related parameter variation was also more obvious.5. Combined carotid artery and radial artery examination can improve the early prediction coronary heart disease.
|
PDF Full Text Request