多层螺旋CT测量心外膜脂肪体积与冠心病的相关性研究  

Study on MSCT evaluation of epicardial fat volume to coronary artery disease

作　　者：贺燕林[1] 王永和 占玲[3] 许克群[3] 郝宏毅[3] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏卫生厅体检康复保健中心,宁夏银川750011 [3]宁夏自治区人民医院,宁夏银川750021

出　　处：《宁夏医学杂志》2010年第3期195-197,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(NZ09153)

摘　　要：目的研究疑似心绞痛患者多层螺旋CT(MSCT)测定的心外膜脂肪体积与冠心病的关系。方法对60例疑似心绞痛患者进行MSCT冠脉造影检查,通过AW4.3工作站的Volume Viewer专用程序逐层手动跟踪心脏,调整脂肪阈值为-250—-30HU获得心外膜脂肪体积,其中16例同时给予腹部MSCT扫描,测定腹部总脂肪、内脏脂肪、皮下脂肪体积,分析心外膜脂肪与冠心病及其危险因素的关系。结果无粥样硬化组心外膜脂肪体积平均值为142.28cm3,阻塞性粥样硬化组(管腔狭窄≥50%)为175.82 cm3,两组心外膜脂肪体积差异有统计学意义(P<0.01)。心外膜脂肪体积与冠脉狭窄呈正相关(OR=1.025>1)。心外膜脂肪体积与身高、体重、体质指数、腹部内脏脂肪体积显著相关。结论心外膜脂肪体积是冠心病的一个独立危险因素,可以作为冠心病预测评估的一个非侵袭性指标。Objective To evaluate whether MSCT evaluation of epicardial fat volume （EFV） is related to coronary artery disease in suspected anginal cases. Methods 60 coronary artery of suspected anginal cases were evaluated by muhislice computed tomographic coronary angiography and digital subtraction arteriography coronary angiography, and a protocol was devised to measure EFV using MSCT. Cross - sectional tomographic cardiac slices （ 2.5 - mm thick） from base to apex were traced semiautomatically using a Volume Viewer of AW4.3 off - line workstation, and EFV was measured by assigning Hounsfield units ranging from - 30 to - 250 to fat. An abdominal CT scan was acquired to measure abdominal visceral fat volume （VFV） , total fat volume （TFV） and subcutaneous fat volume （SFV） from a sample of 16 patients of all the subjects. Results EFV was significantly increased in obstructive atheroselerosis （ luminal narrowing 〉 or = 50% ） group compared with no atherosclerosis group （ 175.82 cm^3 vs. 142.28 cm^3 , P 〈 0. 01 ） . A positive correlation was shown between EFV and coronary arteriostenosis. EFV was correlated with abdominal VAT volume （ r = 0. 646, P 〈 0. 01 ）, body length （ r = 0. 421, P 〈 0. 01 ）, body weight （ r = 0. 433, P 〈 0.01 ）, body mass index （r = 0. 284 ,P 〈 0.05）. Conclusion EFV is an independent risk factor of coronary artery disease. Measurement of EFV may provide another useful noninvasive indicator of heightened risk of CAD.

关 键 词：多层螺旋CT 心外膜脂肪体积 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]