双源64排螺旋CT评价心周脂肪含量与冠状动脉粥样硬化的关系  

Assessment of the relationship between pericardial adipose tissue volume and coronary atherosclerosis with 64-detector dual-source CT

作　　者：刘瑛琪[1] 费军[2] 贾付坤[1] 刘军华[2] 刘莉[1] 张朝利[2] 王晓非[1] 

机构地区：[1]中国人民解放军第306医院心内科,北京100101 [2]中国人民解放军第306医院影像科,北京100101

出　　处：《中国医学影像技术》2011年第11期2227-2230,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用双源CT(DSCT)评估心周脂肪组织(PAT)含量与冠状动脉粥样硬化的关系。方法回顾性分析1102例因胸痛怀疑冠心病而接受DSCT冠状动脉造影的患者的影像学资料。采用CT平扫图像测定冠状动脉钙化积分和PAT含量。根据造影结果将患者分为<50%狭窄组和≥50%狭窄组,根据血管受累情况分为无病变组、单支病变组和2支及以上病变组。按照选择性冠状动脉造影的15段分类法计算Gensini积分。结果冠状动脉≥50%狭窄组PAT容量较<50%狭窄组明显增加(P<0.01),随病变累及支数的增加,PAT容量呈上升趋势,组间差异有统计学意义(P<0.05)。多元回归分析显示,调整年龄和性别因素后,PAT容量与≥50%狭窄的出现高度相关(β回归系数为17.78,P<0.05),与体质量指数、腰围、低密度脂蛋白水平升高相关(P<0.05),但与冠状动脉钙化积分、Gensini积分无相关性(P均>0.05)。结论 PAT容量增多与冠状动脉粥样硬化病变的发生相关,测定PAT含量有助于发现冠心病高危因素。Objective To investigate the relationship between pericardial adipose tissue （PAT） volume and coronary atherosclerosis with dual source CT （DSCT）. Methods DSCT were performed on 1102 consecutive patients who presented with chest pain. Coronary calcium score and PAT volume were measured using plain scan images of DSCT. The patients were divided into 2 groups （stenosis 〈50% or ≥50%） according to the extent of stenosis diagnosed with CT angiography. According to the number of vessel involved, the patients were divided into non-lesion group, single vessel group and ≥2 vessels group. Gensini score was calculated using the 15 segments category methods of CAG. Results PAT volume increased significantly in stenosis ≥50% group compared with stenosis 〈50% group （P〈0.01）. The more the involved vessels, the larger the PAT volume （P〈0.05）. Multiple regression analysis showed that after age and sex were adjusted, PAT volume was significantly associated with stenosis ≥50 % （β regression coefficient was 17.78, P〈0.05）, higher body mass index, waist circumference and higher LDL-C level （P〈0.05）, but no correlation with coronary calcium score and Gensini score was found （both P〉0.05）. Conclusion The increase of PAT volume correlates with coronary atheromatosis. Measurement of PAT helps to indicate heightened risks of coronary artery disease.

关 键 词：心周脂肪 体层摄影术 X线计算机 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]