超声测量的心外膜脂肪厚度与心房颤动的相关性  

The correlation of epicardial adipose tissue thickness and atrial fibrillation by echocardiography

作　　者：张梅青[1] 李越[2] 王秋霜[1] 翟亚楠[2] 魏丽群[2] 黄党生[1] 

机构地区：[1]解放军总医院第一附属医院心内科,北京100048 [2]解放军总医院超声科,北京100853

出　　处：《中华医学超声杂志（电子版）》2017年第3期186-192,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声测量的心外膜脂肪(EAT)厚度与心房颤动(简称房颤)的相关性。方法选取2014年3月至2016年6月解放军总医院第一附属医院收治的房颤患者138例,其中阵发性房颤患者87例,持续性房颤患者51例,另选取窦性心律患者112例作为对照。超声测量所有患者EAT厚度,并记录常规参数。采用单因素方差分析比较阵发性房颤组、持续性房颤组与窦性心律组患者EAT厚度,进一步组间两两比较采用LSD-t检验;采用多因素Logistic回归分析分析房颤发生的危险因素;绘制EAT厚度、左心房内径(LAD)预测房颤发生的操作者工作特征(ROC)曲线;采用Pearson相关分析法分析EAT厚度与LAD的相关性。结果持续性房颤组、阵发性房颤组、窦性心律组患者EAT厚度分别为(4.75±1.83)、(4.32±1.76)、(1.38±0.68)mm。持续性房颤组、阵发性房颤组患者EAT厚度均大于窦性心律组患者,且差异均有统计学意义(t=-9.541、-11.439,P均<0.01);Logistic回归分析结果显示,EAT厚度、LAD是房颤发生的独立危险因素(OR=3.17,95%CI 1.31~7.68,P<0.01;OR=2.65,95%CI 1.69~4.15,P<0.05);ROC曲线显示,EAT厚度、LAD预测房颤发生的曲线下面积分别为0.784、0.865,最佳阈值分别为4.45 mm、40.00 mm;Pearson相关分析结果显示,EAT厚度与LAD呈显著正相关(r=0.512,P<0.01)。结论超声测量的EAT厚度的增加与房颤的发生显著相关,是房颤发生的独立危险因素之一,对预测房颤发生有一定的临床价值。Objective To investigate the association between atrial fibrillation （AF） and epicardial adipose tissue （EAT） by echocardiography. Methods One hundred and thirty-eight patients of AF in First Affiliated Hospital of Chinese People＇s Liberation Army General Hospital from March 2014 to June 2016 were divided into two groups, including paroxysmal AF group with 87 casesand persistent AF group with 51 cases, and 112 cases of sinus rhythm were chosen as control group. Epicardial adipose tissue was measured using echocardiography in all patients, and the conventional parameters were recorded. One-way analysis of variance was used to compare the thickness of EAT in patients with paroxysmal AF group, persistent AF group and sinus rhythm group, and LSD-t test was used in further comparison between two groups. Multivariable logistic regression analysis was used to analyze the risk factors of AF. The receiver-operating characteristic （ROC） cure of EAT and left atrium diameter （LAD） were drawn to predict the incidence of AF. The correlation between EAT thickness and LAD was analyzed by Pearson correlation analysis, Results The thickness of EAT in patients with persistent AF, paroxysmal AF and sinus rhythm group were （4.75_＋ 1.83）,（4.324-1.76） and （1.38 4-0.68） mm, respectively. Epicardial adipose tissue was significantly larger in paroxysmal AF and persistent AF patients compared with that of sinus rhythm group, and the differences were statistically significant （t=-9.541, -11.439, both P 〈 0.01）. Logistic regression analysis indicated that EAT thickness and LAD were independent risk factors of atrial fibrillation （odds ratio： 3.17, 95% confidence interval： 1.31-7.68, P 〈 0.01; odds ratio： 2.65, 95% confidence interval 1.69-4.15, P 〈 0.05）. The area under the curve （AUC） of EAT and LAD to predict presence olAF were 0.784 and 0.865, and the best threshold value were 4.45 mm and 40.00 mm, respectively. Pearson correlation analysis showed that the EAT thickness and LAD had s

关 键 词：心外膜脂肪 心房颤动 超声心动描计术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.75[医药卫生—诊断学]