心外膜脂肪体积与冠状动脉病变及其严重程度的相关性研究  

Relationship between epicardial fat volume and coronary lesions and the severity

作　　者：薄晓红[1,2] 马礼坤[2] 范吉利[2] 蒋哲[2] 周元松[2] 张磊[2] 李万军[2] 高鹏芝 

机构地区：[1]安徽医科大学附属省立医院,合肥230001 [2]太和县人民医院,太和236600

出　　处：《安徽医科大学学报》2016年第6期850-854,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅科技计划项目(编号:12010402c193)

摘　　要：目的通过256层螺旋CT冠状动脉成像(CTA)测量心外膜脂肪体积(EATV),探讨EATV与冠状动脉病变及其严重程度的相关性。方法选取符合条件者208例,以CTA检查未见任何冠状动脉狭窄者为非冠心病组,共计48例,其余为冠心病组160例。收集所有病例的临床一般资料,常规检测空腹血糖、血脂、肝肾功能等生化指标。对适宜的入选患者首先行256层螺旋CTA检查,检测冠状动脉病变情况并同时测量EATV。对冠状动脉CTA检查显示有冠状动脉病变的患者,在同一次住院期间进一步采取冠状动脉造影(CAG)检查明确其冠状动脉病变的情况,采用Gensini积分系统评定冠状动脉病变严重程度,分析和比较EATV的大小与冠状动脉病变及其严重程度的相关性。结果冠心病组EATV平均值明显大于非冠心病组,两组差异有统计学意义(P<0.01)。各组之间EATV的大小差异有统计学意义(P<0.05),冠状动脉狭窄程度的Gensini积分与EATV的大小呈正相关性(r=0.285,P<0.05)。EATV的大小随着患者病变支数增加而增加。利用多因素Logistic回归模型校正其他混杂因素后,显示EATV是冠心病发生的独立危险因素(OR=1.023,P<0.05)。结论 EATV的大小与冠状动脉病变严重程度显著相关,EATV越大冠状动脉病变程度越重;EATV是冠心病发生的一个独立危险因素。Abatract Objective To evaluate the correlation of epicardial adipose tissue（ EATV） with the coronary artery lesion and its severity. Methods 208 qualified cases were selected for the study. They were divided into two groups： one was non coronary heart disease（ CHD） group on the basis of the CAT inspection that showed no coronary artery stenosis. And there were total 48 such cases. The other 160 cases were in the CHD group. We collected general clinical data of all the cases,and did the routine tests on biochemical indexes,such as Glu,blood lipid,hepatic and renal function and so on. First,we did the 256-slice spiral CAT inspection to the qualified patients,inspected the coronary artery lesions and measured EATV at the same time. After doing CTA inspection,if it showed the lesions had occurred to some patients,we would take a further step to do a CAG inspection for these patients to make the conditions of the coronary artery lesions clear. Then we assessed the severity of the coronary artery lesions,analyzed and compared the relevance of the size of EATV and severity of the coronary artery lesions by Gensini points system. Results The average EATV in CHD group was significantly larger than that in non-CHD group. The difference between the two groups was statistically significant（ P 〈0. 01）. The sizes of EATV in each group were significantly different（ P 〈0. 05）. Gensini points of the degree of coronary artery stenosis was positively related to the size of EATV（ r = 0. 285,P 〈0. 05）. The size of EATV was larger with the increase of lesion index of the patient. After rectifying other confounding factors through multiple-factor logistic regression model,it showed that EATV was an independent risk factor causing CHD. Conclusion EATV is closely related to the severity of coronary artery lesions： the larger the EATV,the more severe the coronary artery lesions. Moreover,EATV is an independent risk factor of CHD.

关 键 词：心外膜脂肪体积 冠状动脉病变 冠状动脉血管造影 体层摄影术X计算机 

分 类 号：R541.1[医药卫生—心血管疾病]