心外膜脂肪组织厚度与扩张型心肌病患者左室重构及左室功能不全的关系分析  

Relation between epicardial adipose tissue thickness and left ventricularremodeling in dilated cardiomyopathy patients

作　　者：李春来[1] 许贤彬[1] 吴平彬[1] 

机构地区：[1]广东省潮州市中心医院心血管内科,521000

出　　处：《中国医师进修杂志》2017年第4期367-369,372,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨心外膜脂肪组织（EAT）厚度与扩张型心肌病（DCM）患者的左室重构和左室功能不全的相关性.方法 选择2012年2月至2016年2月收治的108例DCM患者（观察组）以及90例健康体检人员（对照组）,以心脏彩色多普勒超声对两组如下指标进行测量,包括左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）、左室收缩末期容积指数（LVESVI）、左室舒张末期容积指数（LVEDVI）、左室收缩末期球形指数（SIS）、左室舒张末期球形指数（SID）、左室射血分数（LVEF）以及EAT厚度,统计分析两组各指标的差异及相关性.结果 与对照组比较,观察组LVESD、LVEDD、LVESV、LVEDV、LVESVI、LVEDVI及EAT厚度均明显升高,而LVEF、SIS及SID均明显下降,差异均有统计学意义（P＜0.05）.观察组心功能NYHA分级Ⅱ级患者EAT厚度为（8.1±1.8） mm,Ⅲ级患者为（7.8±2.0） mm,Ⅳ级患者为（7.9±1.7） mm,亚组间比较差异无统计学意义（F=1.973,P＞0.05）.线性相关分析提示,EAT厚度与LVESD、LVEDD、LVESV、LVEDV、LVEDVI、LVESVI、SIS及SID均呈正相关性（r=0.247、0.231、0.256、0.267、0.293、0.281、0.261、0.237,P＜0.05）,与LVEF未见相关性（r=0.132,P＞0.05）.Logistic多因素回归分析提示EAT厚度可作为DCM患者左室重构一项独立的危险因素（OR=0.793,95％ CI：0.431～1.734,P=0.039）.结论 EAT厚度与DCM患者左室重构有显著相关性,可作为预测左室重构的独立危险因素.Objective To study the relation of epicardial adipose tissue （EAT） thickness with 1eftventricular remodeling and dysfunction in dilated cardiomyopathy （DCM） patients.Methods One hundred and twenty DCM patients who received treatment from Febuary 2012 to February 2016 were served as DCM group,and 76 healthy subjects undergoing physical examination were served as control group.Their left ventricular end-diastolic diameter （LVEDD）,left ventricular end systolic diameter （LVESD）,left ventricular end diastolic volume （LVESV）,left ventricular end systolic volume （LVEDV）,left ventricular end diastolic volume index （LVEDVI）,left ventricular end systolic volume index （LVESVI）,sphericity index （SI）,leftventricular ejection fraction （LVEF）,and EAT thickness were measured by routine cardiac ultrasonography and compared between two groups.Results The levels of LVESD,LVEDD,LVESV,LVEDV,LVESVI,LVEDVI and EAT thickness in DCM group were significantly higher,and the levels of LVEF,SIS and SID in DCM group were significantly lower （P＜0.05）.The EAT thickness in DCM group with NYHA class Ⅱ,Ⅲ,Ⅳ was （8.1 ± 1.8）,（7.8 ± 2.0）,（7.9 ± 1.7） mm,and there was significant difference （F=1.973,P＞ 0.05） Linear correlation analysis showed that the EAT thickness was positively related with the LVESD,LVEDD,LVESV,LVEDV,LVEDVI,LVESVI,SISand SID （r =0.247,0.231,0.256,0.267,0.293,0.281,0.261,0.237,P＜0.05）.There was no relationship between EAT thickness and LVEF （r =0.132,P＞ 0.05）.Logistic multifactor regression analysis showed that EAT thickness was an independent risk factor for left ventricular remodeling in DCM patients （OR =0.793,95％CI：0.431-1.734,P =0.039）.Conclusions The EAT thickness is significantly related with the left ventricular remodeling and can be used as an independent risk factor for predicting left ventricular remodeling in DCM patients.

关 键 词：心肌病 扩张型 脂肪组织 心室重构 心室功能障碍 左 

分 类 号：R542.2[医药卫生—心血管疾病]