超声检测心外膜脂肪组织联合缺血修饰白蛋白在冠心病诊断中的应用价值  

Application value of ultrasonic detection of epicardial adipose tissue combined with ischemia modified albumin in diagnosis of coronary heart disease

作　　者：肖建东[1] 张俊岭[1] 路玉李 张淑枝[1] 马星[3] 郑群[1] 

机构地区：[1]衡水市哈励逊国际和平医院心内科,衡水053000 [2]衡水市哈励逊国际和平医院内分泌科,衡水053000 [3]衡水市哈励逊国际和平医院超声科,衡水053000

出　　处：《中国循证心血管医学杂志》2017年第6期687-689,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：衡水市科学技术研究与发展计划项目(14020A)

摘　　要：目的心脏超声检测心外膜脂肪组织(EAT)厚度联合血清缺血修饰白蛋白(IMA)浓度在冠状动脉粥样硬化性心脏病(冠心病)诊断中的价值。方法选择2014年5月~2015年12月于衡水市哈励逊国际和平医院就诊的150例冠心病患者作为病例组,经Judkins冠状动脉造影法检查后根据造影结果分组,包括单支病变组、双支病变组和多支病变组各50例。选择同期在我院进行体检的50例健康人群作为对照组,所有入选者均行超声心动图测定心外膜脂肪组织厚度,采用白蛋白-钴离子结合试验法测定血清IMA浓度。结果冠心病患者单支病变组、双支病变组和多支病变组EAT厚度和IMA浓度均明显高于对照组,差异有统计学意义(P<0.01)。ROC曲线示EAT厚度为6.03 mm时,灵敏度为52.16%,特异度为86.3%;血清IMA浓度为72 U/L时,灵敏度为76%,特异度为72.2%。将二者联合诊断,串联试验时,灵敏度为39.26%,特异度为95.76%;并联试验时,灵敏度为87.2%,特异度为64.31%。结论超声检测EAT厚度和血清IMA浓度对冠心病诊断具有一定参考价值,二者联合诊断,可显著提高冠心病的诊断率和准确率。Objective To discuss the value of cardiac ultrasonic detection of epicardial adipose tissue （EAT） combined with ischemia modified albumin （IMA） in diagnosis of coronary heart disease （CHD）. Methods CHD patients （n=150） were chosen into case group from the Harrison International Peace Hospital in Hengshui City from May 2014 to Dec. 2015, and then divided, according to the results of Judkins coronary angiography, into 1-vessel lesion group, 2-vessel lesion group and multi-vessel lesion group （each n=50）. At the same time the health controls （n=50） had physical examinations were chosen into control group. All groups were given echocardiogram for detecting the thickness of EAT, and concentration of serum IMA was detected by using albumin cobalt binding test （ACB test）. Results The thickness of EAT and concentration of serum IMA were significantly higher in 1-vessel lesion group, 2-vessel lesion group and multi-vessel lesion group than those in control group （P〈0.01）. When receiver operating characteristic curve （ROC） showed that thickness of EAT was 6.03 mm, the sensitivity was 52.16% and specificity was 86.3%. When concentration of serum IMA was 72U/L, the sensitivity was 76% and specificity was 72.2%. When thickness of EAT combined with concentration of serum for diagnosis in serial tests, the sensitivity was 39.26% and specificity was 95.76%, and when the test in parallel, the sensitivity was 87.2% andspecificity was 64.31%. Conclusion The ultrasonic detection of EAT thickness and serum IMA concentration has some reference value in the diagnosis of CHD, and the combination of them can significantly increase the correct diagnosis rate and accuracy rate.

关 键 词：冠心病 心脏超声 心外膜脂肪组织 缺血修饰白蛋白 联合诊断 

分 类 号：R541.4[医药卫生—心血管疾病]