冠心病患者心外膜脂肪体积与血管重构类型有关联  

Association of human epicardial adipose tissue volume,inflammatory mediators with positive vascular remodeling

作　　者：周亮亮[1] 宫剑滨[1] 李德闽[2] 卢光明[3] 陈栋[1] 王璟[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院心脏内科,江苏南京210002 [2]南京大学医学院临床学院南京军区南京总医院心胸外科,江苏南京210002 [3]南京大学医学院临床学院南京军区南京总医院医学影像科,江苏南京210002

出　　处：《心脏杂志》2015年第1期27-30,共4页Chinese Heart Journal

基　　金：南京军区医学科技创新重点项目资助(09Z026);江苏省"六大人才高峰"项目资助(WS-078);南京军区南京总医院青年基金项目资助(2009Q003)

摘　　要：目的:观察分析冠心病患者心外膜脂肪体积(EATV)与血管重构类型的相关性。方法:行64排双源CT评估冠状动脉狭窄程度并测定EATV,同期行外周血脂、胰岛素抵抗指数等检测。经数字减影血管造影(DSA)确诊冠心病患者180例。经CT血管造影(CTA)图像测定斑块重构指数(RI),根据RI将患者分为正性重构组(80例)和负性/无重构组(100例),并分析其与EATV的相关性。结果:正性重构组的EATV显著增加[(128±42)cm3vs.(95±25)cm3]。logistic回归分析显示EATV是影响正性重构的独立危险因素。结论:EATV是影响冠心病病变血管正性重构的独立危险因素。AIM： To investigate whether epicardial adipose tissue volume （EATV） is correlated with vascular remodeling in patients presenting with coronary heart disease （CHD）. METHODS： A total of 180 patients were assessed for severity of coronary artery stenosis and EATV by 64-slice dual-source cardiac computed tomography （CT） scans. One hundred eighty patients were confirmed to have CHD utilizing digital subtraction angiography （DSA） and the other 80 patients were classified as non-CHD. Vascular remodeling indices and plaque vulnerability parameters （lipid plaque volume, fibrous plaque volume, and calcified plaque volume） were measured in order to determine any significant correlations with EATV. RESULTS： Analysis of CHD patients demonstrated that EATV in patients with positive remodeling was significantly higher [ （128±42） cm^3 vs. （95±25 ） cm^3] than the non-positive remodeling group. Logistic regression analysis indicated that EATV is an independent risk factor for positive vascular remodeling. In the CHD group, EATV was positively correlated with lipid plaque volume and negatively correlated with fibrous/calcification plaque volume （P 〈 0. 05 ）. CONCLUSION： Epicardial adipose tissue volume （EATV） is significantly correlated with positive remodeling in coronary heart disease.

关 键 词：心外膜脂肪 冠状动脉疾病 易损斑块 血管重构 

分 类 号：R541.4[医药卫生—心血管疾病]