| Objective: Globally,cardiovascular disease is the leading cause of human health,coronary atherosclerosis heart disease(coronary heart disease,CHD)is a disease of heart blood-vessel of accounts for one of the diseases is higher,the prognosis is poor.With the improvement of the living environment of the Chinese people,the drastic changes in lifestyle caused CHD risk factors to increase and the number of CHD cases increasing.The incidence of CHD in China is lower than that in the United States and Europe,but China has a larger population,so the number of CHD is huge,which seriously threatens the health of people and increase heavy social burden.Atherosclerosis(AS)is a disease that develops with age and it’s a disease with systemic vascular system.Due to cervical fascia tissue relatively shallow,Carotid Atherosclerosis(Carotid Atherosclerosis,CAS)is easy to detect,evidence-based medicine has confirmed the Carotid intima-media thickness,plaque formation,and systemic vascular Atherosclerosis have good correlation by CAS lesions situation can be speculated that general situation of systemic Atherosclerosis.Carotid artery and coronary artery both belong to secondary blood vessels of the body,both have a common physiological base and risk factors of pathological changes,research on disease in both the domestic and foreign experts and scholars has carried out a series of studies since the 1990 s.Type B ultrasound was introduced in 1972 because of its non-invasive,relatively low technical and equipment requirements,low price and high accuracy.Ultrasonography can directly observe the carotid artery lumen,which is relatively ask low in the requirements of personnel technology and hardware,can be repeated measurement,no side effects,as a means of disease screening,has a large clinical advantage.The purpose of this paper is to explore the effectiveness of CAS index,especially the neck vulnerability plaque in predicting the severity of CHD patients,and provide some support for the early stage detection,diagnosis and risk stratification of CHD.Methods: Continuous selection Chengde medical school second affiliated clinical hospital 315 cases of hospitalized patients with coronary angiography in March 2016 to March 2018 and those patients all allown to provide hospital clinical baseline data within 24 hours.Coronary angiography was performed within 1 week of hospitalization,and computer software was used to integrate the SYNTAX score according to the computer records.The patient had signed informed consent after admission and improved the ultrasonic examination of the neck artery during the admission.Main detection of Common Carotid Artery(CCA),Internal Carotid Artery(ICA),observation: 1.Anatomy of the Carotid Artery;2.The thickness of carotid artery was observed,and the mean value of the maximum thickness of carotid artery and internal carotid artery was observed respectively.3.Characteristics of carotid artery plaques,including(the location of each patch,total number of plaques,maximum thickness of each patch,the nature of the plaques and the analysis of the echo of the plaques).Finally,the Crouse points of the carotid artery were calculated by adding each plaque thickness,and the grading score was evaluated according to the patch condition.4.The carotid artery was observed to be unobstructed,and the stenosis of the carotid artery was recorded in the case of stenosis.In this study,315 patients with CHD were divided into the control group(0 points)and the mild group(1≤SYNTAX score <21),and the moderate group(21≤SYNTAX score <31)and the severe group(31≤SYNTAX integral).Analysis of carotid intima-media Thickness(Intima Media Thickness,IMT),the total number of patch and cases of the neck patches overall properties,carotid artery levels,carotid artery plaque Crouse integral,the relationship between the degree of carotid stenosis and SYNTAX score,SPSS21 by computer.0 software performs statistical analysis of the collected data.According to the standard deviation of the measurement data,the single-factor variance analysis was used to determine the normal distribution.When the test result rejected the original hypothesis,the s-n-k method was used to compare the two groups.The count data was expressed in %,and the chi-square test was used for the comparison between groups.The correlation of counting data was analyzed by spearman correlation,and the correlation of metering data was analyzed by Pearson correlation,and P < 0.05 was considered statistically significant.Results: SYNTAX integral results: a mild group(1≤ SYNTAX score <21),124 cases of moderate group(21 ≤ SYNTAX score <31),and 45 cases of severe group(31≤ SYNTAX score),and 83 cases in the control group(0).1.Comparison between the IMT,grade points and Crouse scores of carotid artery in each group: there were statistically significant differences between the carotid artery IMT,grade points and Crouse scores in each group.Comparison between groups: the experimental group was significantly higher than the control group(P < 0.05).The severe group was significantly higher than the moderate group and the mild group(P < 0.05).The moderate group was significantly higher than the mild group and the control group(P < 0.05),and the mild group was significantly higher than the control group(P < 0.05).2.Carotid artery plaques in each group: in the control group,there were 83 cases patients,and 24 patients with smooth carotid artery,accounting for 28.92%,and 59 cases with plaque,accounting for 71.08%.There were 124 cases in the mild group and 14 patients with smooth carotid artery without plaque,accounting for 11.29% and 110 cases with plaque,accounting for 88.71%.There were 63 patients in the moderate group,and 0 cases of smooth carotid artery without plaque,accounting for 0%,and there were 63 patients with plaque,accounting for 100%.In the severe group,there were 45 cases,and the carotid artery smooth without plaque was 0,accounting for 0%,and there were 45 cases with plaque,accounting for 100%.3.Vulnerable plaque of the neck in each group:there were a total of 83 patients in the control group.In the control group,there were 83 cases,and there were 43 cases of carotid artery plaques with homogenous plaques,and 16 cases with mixed plaques.In the light group,there were 124 cases of carotid artery plaques in 74 cases,and 36 cases with mixed plaques.In the moderate group,there were 63 patients with carotid artery plaques in 18 cases,and 45 patients with mixed plaques.In the severe group,45 cases of carotid artery plaques were all homogenous plaques,with 30 cases of mixed plaques.4.Neck patch echo properties in each group: control group in 209 the total number of patches,uniformity low(or)under ultrasonic echo plaques 80,accounted for 38.4%,high heterogeneity echo plaques 87,accounted for 41.6%,low echo 21 mixed echo plaques,accounted for 10%,high echo 21 mixed echo plaques,accounted for 10%;Mild group of 405,the total number of patches under ultrasound low heterogeneity(or)206 echo plaques,accounted for 50.9%,high heterogeneity echo plaques 80,accounted for 19.7%,low echo 57 mixed echo plaques,accounted for 14.1%,high echo mixed echo plaques,62,accounted for 15.3%;Moderate groups to the total number of patches,84,under the ultrasonic uniformity low(or)33 echo plaques,accounted for 39.3%,high heterogeneity echo plaques 18,accounted for 21.4%,low echo 15 mixed echo plaques,accounted for 17.9%,high echo 18 mixed echo plaques,accounted for 21.4%;Severe groups to the total number of patches,21,ultrasonic under low heterogeneity(or)nine echo plaques,accounted for 42.8%,six high heterogeneity echo plaques,accounted for 28.6%,low echo 6 mixed echo plaques,accounted for 28.6%,high echo zero mixed echo plaques,accounted for 0%.5.SYNTAX integral has a good correlation with IMT,grade integral and Crouse integral(r=0.470,0.639,0.647,P< 0.05),and SYNTAX integral has a significant correlation with carotid atherosclerosis(P<0.01).SYNTAX integral was not associated with carotid stenosis(P> 0.05).6.To follow-up 1 month after discharge of the patient outcome,evaluation of the effect of hospital patients have said: no Major Adverse Cardiac events(Major Adverse Cardiac events,MACE),have different levels to improve the quality of life,are satisfied.Conclusion: With the increase of SYNTAX integral,the number of carotid artery vulnerable plaques gradually increased,especially with the low echo-dominated mixed echo plaques.Mixed echogenic plaques based on low echo are of certain predictive value for coronary heart disease.In this study,as the SYNTAX score increased,in addition to the severe group,the rest of the three groups is given priority to with low echo increased number of mixed echo plaques,in SYNTAX 31 points below,within the scope of the low echo is given priority to the number of mixed echo plaques has certain prediction for disease and statistical analysis between groups(P < 0.05).The difference was statistically significant.Therefore,in the process of systemic vascular sclerosis of arterial congee appearance,the neck of the vulnerable plaques,especially those with low echo of mixed echo plaques on the severity of coronary atherosclerosis has certain prediction effect.Carotid artery ultrasonography,such as a mixed echogenic plaque with low echo,is of predictive significance for CHD patients,and it is recommended to actively pay attention to clinical symptoms and conduct coronary angiography in a timely manner.The higher the SYNTAX score is,the more obvious the CAS is,and the occurrence of vulnerable plaque is closely related to the occurrence of CHD,which may be a risk factor for the early development of coronary heart disease,and the value of further study is discussed.There was no difference in short-term prognosis of CHD patients. |
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