Abstract: Objective　To analyze the application value of carotid ultrasound combined with cardiac color ultrasound in screening coronary heart disease (CHD). Methods　A total of 114 patients suspected with CHD at Yingkou Central Hospital were selected, including 68 males and 46 females. They were 32-78 (58.76±7.54) years old. All the patients underwent carotid ultrasound and cardiac color ultrasound examinations. The coronary angiography was the golden standard. They were divided into a CHD group and a non-CHD group. The ultrasound examination indicators [carotid intima-media thickness (IMT), plaque score, and Tei index] were compared between the CHD group and the non-CHD group and between the CHD patients with different lesions. And correlation analysis was conducted. The diagnostic efficiency of carotid ultrasound combined with cardiac color ultrasound was analyzed by the receiver operator characteristic curve (ROC). The independent-sample t test was used for the comparison between two groups. The one way ANOVA was used for the comparison between 3 or more than 3 groups. Results　The carotid IMT, plaque score, and Tei index in the CHD group were significantly higher than those in the non-CHD group [(1.29±0.20) mm vs. (0.68±0.11) mm, (2.25±0.32) vs. (0.86±0.14), and (0.58±0.09) vs. (0.42±0.06); all P<0.05]. The carotid IMT, plaque score, and Tei index in the multi-vessel lesion group were higher than those in the double-vessel lesion group and those in the single-vessel lesion group (all P<0.05), and those in the double-vessel lesion group were higher than those in the single-vessel lesion group (all P<0.05). The vessel number of lesions was positively correlated with the carotid IMT, plaque score, and Tei index (all P<0.05). The areas under the ROC's (AUC) of carotid IMT, plaque score, Tei index, and their combination were 0.781, 0.765, 0.703, and 0.897, respectively. The sensitivity and specificity of the combination were 91.4% and 72.3%, respectively. Conclusion　Carotid ultrasound combined with cardiac color ultrasound can effectively improve the diagnostic efficiency of CHD, which is of important application value in CHD screening.

Key words: Coronary heart disease, Carotid ultrasound, Cardiac color ultrasound, Coronary angiography, Screening

摘要： 目的　分析颈动脉超声联合心脏彩色超声（彩超）超检查在冠心病筛查中的应用价值。方法　选取2019年5月至2020年9月营口市中心医院收治的114例疑似冠心病患者，男68例，女46例，年龄32～78（58.76±7.54）岁，均接受颈动脉超声与心脏彩超检查，以冠状动脉造影为“金标准”，将其分为冠心病组与非冠心病组，比较冠心病组与非冠心病组、不同病变冠心病患者超声检查指标［颈动脉内膜-中层厚度（IMT）、斑块积分及Tei指数］，进行相关性分析，并使用受试者工作特征曲线（ROC）分析颈动脉超声联合心脏彩超诊断效能。两组比较采用独立样本t检验，多组比较采用单因素方差分析。结果　冠心病组颈动脉IMT、斑块积分及Tei指数均明显大于非冠心病组［（1.29±0.20）mm比（0.68±0.11）mm、（2.25±0.32）分比（0.86±0.14）分、（0.58±0.09）比（0.42±0.06），均P<0.05］；多支病变组颈动脉IMT、斑块积分及Tei指数明显大于双支病变组与单支病变组（均P<0.05），且双支病变组明显大于单支病变组（均P<0.05）；冠心病患者病变支数与颈动脉IMT、斑块积分、Tei指数呈正相关（均P<0.05）；颈动脉IMT、斑块积分、Tei指数及联合诊断曲线下面积（AUC）分别为0.781、0.765、0.703、0.897，联合诊断灵敏度与特异度分别为91.4%、72.3%。结论　颈动脉超声联合心脏彩超能够有效提高冠心病诊断效能，在冠心病筛查中具有重要应用价值。

关键词: 冠心病, 颈动脉超声, 心脏彩色超声, 冠状动脉造影, 筛查