超声测量心外膜脂肪组织厚度与血管内超声检测冠状动脉病变的相关性  

Correlation Between Epicardial Adipose Thickness Using Ultrasound and Coronary Artery Disease Using Intravascular Ultrasonography

作　　者：高伟栋[1] 张高星[1] 张红环[1] 彭宇程[1] 赖浚兴[1] 张学芳[1] 

机构地区：[1]中山大学附属江门医院心血管内科,广东江门529071

出　　处：《中国医学影像学杂志》2013年第7期526-529,533,共5页Chinese Journal of Medical Imaging

摘　　要：目的评价经超声测量心外膜脂肪组织厚度(EAT)对冠状动脉狭窄程度的预测价值。资料与方法 92例患者行冠状动脉血管内超声检查,根据结果分为冠心病组和非冠心病组;冠心病组进一步分为轻度组、中度组、重度组;经超声测量EAT,比较各组EAT,分析冠心病患者EAT与冠状动脉面积狭窄率、冠状动脉病变积分(CAS)的相关性,观察EAT与冠心病的关系。结果 92例患者中,冠心病组67例,其中轻度组19例,中度组36例,重度组12例;非冠心病组25例。冠心病组EAT显著大于非冠心病组(t=-5.35,P<0.05);冠心病轻度组、中度组、重度组间随病变程度加重,EAT逐渐增大(F=9.8,P<0.01)。EAT与冠状动脉面积狭窄率(r=0.379,P<0.01)及CAS(r=0.67,P<0.05)呈正相关;Logistic回归分析显示,EAT是冠心病的独立危险因子(Wald=5.057,P<0.05)。EAT>5.16mm诊断冠心病的敏感度为83.6%,特异度为68.0%,ROC曲线下面积为0.0822。结论超声测量EAT评价冠状动脉病变程度简便、可靠、实用,EAT与冠心病关系密切,可以辅助诊断冠心病。Purpose To evaluate the value of epicardial adipose thickness （EAT） using ultrasound to predict the degree of coronary artery stenosis. Materials and Methods Ninety-two patients received coronary artery intravascular ultrasonography were divided into coronary heart disease （CHD） group and non-coronary heart disease （NCHD） group according to the results, and the CHD group was further divided into mild, moderate and severe group. The correlation of EAT with the coronary area stenosis ratio and coronary artery score （CAS） was investigated, and the relationship between EAT and CHD was observed. Results Of 92 patients, CHD group had 67 cases, including the mild group 19 cases, moderate group 36 cases and severe group 12 cases, and NCHD group had 25 cases. EAT of CHD was larger than that of NCHD group significantly （t=- 5.35, P〈0,05）. As the lesion degrees of the mild, moderate and severe group of CHD aggravated, EAT were gradually increased （F=9.8, P〈0.01）. EAT showed positive correlations with coronary area stenosis ratio （r=0.379, P〈0.01） and CAS （r=0.67, P〈0.05）. The Logistic regression analysis showed that EAT was independent risk factor of CHD （Wald=5.057, P〈0.05）. EAT〉5.16 mm showed 83.6% of sensitivity and 68.0% of specificity for the diagnose, and the area under the ROC curve was 0.0822. Conclusion EAT measured by ultrasound is simple, reliable and practical to evaluate CHD lesion degree. EAT is closely associated CHD and will be help for the diagnosis of coronary heart disease.

关 键 词：冠心病 超声心动描记术 超声检查 介入性 心包 脂肪组织 冠状动脉 狭窄 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]