正常体型老年人心外膜及冠状动脉周围脂肪组织与冠心病的相关性  

The relationship between epicardial adipose tissue and peri-eoronary adipose tissue of normal figured aged people with coronary artery disease

作　　者：史凯蕾[1,3] 钱菊英[1] 齐琳[2] 毛定飚[2] 陈阳[3] 朱毅[3] 郭新贵[3] 

机构地区：[1]复旦大学附属中山医院心内科,上海市200032 [2]复旦大学附属华东医院影像科,上海市200040 [3]复旦大学附属华东医院心内科,上海市200040

出　　处：《老年医学与保健》2014年第1期20-24,共5页Geriatrics & Health Care

基　　金：国家自然基金（81370322）

摘　　要：目的探讨正常体型老年人心外膜及冠状动脉周同脂肪组织与年轻人的差别，以及这些脂肪组织与冠状动脉粥样硬化的相关性。方法60例同时行冠脉CT及冠状动脉造影的体型正常的老年患者及16例冠脉CT正常的中青年对照者，其中老年组按病变程度分为老年正常冠脉组（9例）．老年冠状动脉粥样硬化组（22例）和老年冠心病组（29例）。冠脉CT测定心外膜脂肪容积和厚度，并计算左主干-前降支、回旋支、右冠状动脉周嗣脂肪组纵。结果在冠脉正常者人群中，老年人心外膜脂肪容积较中青年增加[（211，99±12．02）cm3 vs（15066±29，71）cm3，P〈0．001]；老年组左主干-前降支和有冠状动脉周围脂肪较中青年组增加[（8．93±1．10）cm3 vs（7．35±1．80）cm3，P=0．026]和[（11．28±1．64）cm3 vs（10．06±0．69）cm3，P=0．015]，回旋支周同脂肪有增加趋势，老年冠心病组患者心外膜脂肪厚度较正常冠脉组增加[（3．98±1．07）mm vs（3．32±0．47）mm，P=0．03]，两组之间心外膜脂肪容积的差异无统计学意义[（240．46±53．45）cm3 vs（211．98±12．02）cm3，P=0．094]；老年冠心病组左主干-前降支周同脂胁组织较正常冠脉组和轻度动脉粥样硬化组增加[（11．26±1．84）cm3〉（9．86±1．41）cm3〉（8．93±1．10）cm3，P〈0．01和P=0．003]；老年冠心病组有冠状动脉周围脂肪组织较正常冠脉组增加，差异有统计。学意义[（14．14±2．69）cm3 vsS（11．28±1．64）cm3，P=0．003）。结论老年人心外膜脂肪容积以及左主干-前降史和右冠周闻脂肪组织容量均较中青年人增加，老年冠心病患者心外膜脂肪厚度以及左主干-前降支和右冠周围脂肪组织容苗较老年正常冠脉者增加更显著。Objective To elucidate the differences of epicardial adipose tissue （EAT） and pericoronery adipose tissue （PCAT） surrounding the coronary arteries between aged people and young adults. Meanwhile, to study the relationship between these adipose tissues and atherosclerosis. Methods Sixty aged people who underwent coronary CT angiography and coronary angiography were diviede into group 1 （without atherosclerosis）, 2 （with atherosclerosis） and 3 （coronary heart disease） according to the severity of coronary artery disease Sixteen young adults whose coronary CT angiography showed normal coronary arteries were enrolled as control group. The volume and thickness of EAT were measured and the adipose tissue surrounding the LM and LAD, LCX, RCA were scored through coronary CT angiography. Results Among normal coronary artery people, the volume of EAT distinctly increased in aged people as compare to those in young adults [（211.99± 12.02） cm3 vs （150.66±29.71） cm3, P〈0.01]. The PCATs surrounding the LM- LAD, LCX and RCA were tend to increase in aged people, especially for those of LM-LAD and RCA [（8.93±1.10） cm3 vs （7.35±1.80） cm3, P=0.026 and （11.28±1.64） cm3 vs （10.06±0.69） cm3 , P=0.015）. The EAT thicknesses were increased in group 3 have increasd compare with those in group 1 [（3.98±1.07） mm vs （3.32±0.47） ram, P=0.03）, but not the volume of EAT [（240.46±53.45） cm3 vs （211.98±12.02） cm3, P=0.094 ）. The PCATs surrounding LM - LAD in group 3 were significantly increase as compare to those in group 2 and 1 [（11.26±1.84） cm3〉 （9.86±1.41） cm3 〉 （8.93±1.10） cm3,P = 0.003 and P 〈 0.001 ）]. The volumes of PCATs surrounding RCA in group 3 were increased comparing with those in group 1 [（14.14±2.69） cm3 vs （11.28±1.64） cm3, P=0.003]. Conclusion The volumes of EAT and PCAT surrounding LM- LAD and RCA in aged people increase distinctly than those in young adults, The increase of PCAT surrounding I.M-LAD and RCA in aged peo

关 键 词：冠心病 心外膜脂肪 冠状动脉周围脂肪 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]