【摘要】 目的 病理和X线研究已证实主动脉粥样硬化斑块和冠心病相关，但一直未应用于临床。通过胸主动脉超声探查粥样硬化斑块验证其是否为诊断冠状动脉粥样硬化性心脏病(冠心病)的标志。方法 对65例患者行主动脉超声探查粥样硬化斑块。经胸主动脉超声诊断粥样硬化斑块的标准为胸主动脉管腔线样或局部增厚，不规则回声增强和内膜增厚或钙化。结果 65例患者中44例冠脉造影证实至少1支冠状动脉粥样硬化，冠状动脉左主干狭窄>50%，左前降支、左回旋支、右冠脉狭窄>70%。44例患者中39例胸主动脉超声证实存在粥样硬化斑块。65例患者中21例冠脉造影正常或非粥样硬化性管腔狭窄，2例胸主动脉超声探查存在粥样硬化斑块。胸主动脉超声诊断主动脉粥样硬化斑块的敏感性为89%，诊断冠心病的特异性为89%。主动脉粥样硬化斑块对冠心病的肯定预测价值是95%，否定预测价值是79%。结论 胸主动脉超声探查粥样硬化斑块是预测冠心病的标志，临床应进一步研究。

    aortic plaque:A marker for coronary atherosclerotic heart diseases

    Huo Meng，Gao Yajun，Zhang Gang，et al.

    Affiliated Hospital，Academy of Medical Science of Hebei，Shijiazhuang050011.

    【Abstract】 Objective To test the hypothesis that atherosclerotic plaque in the thoracic aorta detected by thoˉracic aortic echocardiographically is a marker for cornary atherosclerotic heart disease.Previous pathologic and roentgenographic studies suggested a relation between aortic plaque and coronary atherosclerotic heart disease but lacked clinical utility.Methods We performed thoracic aortic echocardiographically on65patients(32women and33men，aged24to80years[mean60±12years]，who had previously undergone cardiac catheterization with coronary angiography.The clinical indications for angiography were angina(n=27) ......