MDCT评价冠心病患者心外膜脂肪组织容积与升主动脉弹性的相关性  

Relationship between epicardial adipose tissue and ascending aortic distensibility in patients with coronary artery disease

作　　者：吴磊[1] 查云飞[1] 邢栋[1] 彭宇锋[1] 

机构地区：[1]武汉大学人民医院放射科,武汉430060

出　　处：《放射学实践》2013年第2期154-158,共5页Radiologic Practice

基　　金：国家自然科学基金青年科学基金资助(61002046)

摘　　要：目的:利用64-MDCT评价冠心病患者心外膜脂肪组织(EAT)容积与升主动脉弹性的相关性。方法:对135例拟诊冠心病的受检者行回顾性心电门控技术冠状动脉CTA和冠状动脉造影(CAG)检查,采用GE AW4.4工作站手动勾画心包线并计算EAT容积;测量受试者血压,重组升主动脉0%～95%R-R间期间隔5%的图像,采用MATLAB软件半自动描绘并测量各R-R间期主动脉横断面面积,然后计算出升主动脉弹性值。按冠脉狭窄程度将受检者分为正常对照组(n=56)、无意义冠脉狭窄组(n=36)和有意义冠脉狭窄组(n=43)三组。EAT容积与升主动脉弹性值相关性比较采用Pearson相关分析;使用多重元线性回归分析包括EAT容积在内的与升主动脉弹性相关的各种独立影响因子。结果:正常对照组EAT容积与升主动脉弹性值无相关性(r=-0.24,P=0.074);无意义冠脉狭窄组、有意义冠脉狭窄组EAT容积与升主动脉弹性值间均呈负相关(r=-0.344,P=0.04;r=-0.347,P=0.023);多重元线性回归表明EAT容积是升主动脉弹性值的独立影响因子(B=-0.005,t=-3.037,P=0.003)。结论:冠心病患者EAT容积与升主动脉弹性具有负相关性,EAT容积的MDCT评价有助于早期预警冠心病患者主动脉硬化病变的发生及早期抑脂治疗策略的选择。Objective：To assess the relationship between epicardial adipose tissue （EAT） and ascending thoracic aorta distensibility in coronary artery disease （CAD） patients by using 64 multidetector CT angiography （CTA）. Methods： In all 135 patients with suspected CAD were enrolled in this study and underwent retrospective ECG-gated coronary CTA and CAG. The EAT volume was calculated through depicting the epicardium with AW4.4 workstation （GE）. Every patient＇s blood pressure was measured before and after the coronary CTA respectively. The ascending aortal images of 20 phases between 0%and 95% of the R-R intervals with an increment of 5% was reformatted and the aortal area of the images was measured by MATLAB software,and then we can calculate the aortic distensibility. According to the degrea of severity of coronary stenosis,the patients can be divided into normal subjects （n=56）,non-significant coronary stenosis subjects （n= 36） and significant coronary stenosis subjects （n： 43）. We can evaluate the EAT volume and the aortic distensibility through the linear correlation and multivariate linear regression analysis. Results： In normal subjects, the relationship be- tween the EAT volume and the aortic distensibility was not significant （r= 0.24,P=0. 074）. But in the subjects of non significant coronary stenosis and significant coronary stenosis, the aortic distensibility had a significant relationship with EAT volume （r= -0. 344,P 0.04;r= -0. 347 ,P=0. 023 ,respectively）. Multivariate linear regression demonstrated that EAT volume was an independent risk factor of aortic distensibility （B= 0. 005,t= 3. 037, P = 0. 003）. Conclusion：The EAT volume had a significant negative relationship with the aortic distensibility. The estimation of EAT may play an important role in the prediction of aortic atherosclerosis and selecting therapeutic strategies 1in CAD patients.

关 键 词：冠心病 心外膜脂肪组织 主动脉弹性 体层摄影术 X线计算机 

分 类 号：R541.4[医药卫生—心血管疾病]