超声心动图测量心外膜脂肪层厚度对冠心病的预测价值研究  

The value of quantifying epicardial fat thickness by echocardiography in predicting coronary heart disease

作　　者：李赵欢[1] 欧阳征鹏[1] 罗安果[1] 左明良[1] 邓燕[1] 李春梅[1] 尹立雪[1] 

机构地区：[1]四川省医学科学院.四川省人民医院心血管超声及心功能科,四川成都610072

出　　处：《实用医院临床杂志》2017年第5期47-49,共3页Practical Journal of Clinical Medicine

基　　金：四川省科技厅项目(编号:2016TD0017;2017TD0015);四川省人民医院青年科研基金项目(编号:30305031078P)

摘　　要：目的探讨心外膜脂肪层厚度对冠心病的预测价值。方法选择拟诊为冠心病,拟行冠状动脉造影的患者83例,根据临床诊断结果分为3组:急性冠脉综合征(acute coronary intervention,ACS)组36例,稳定型心绞痛(stable angina,SA)组28例及对照组19例。采集胸骨旁左心室长轴切面和心尖四腔心切面的二维动态图像,分别测量舒张末期冠状沟与心尖切迹中间的右室前壁前、左心室后壁后以及心尖切迹处的心外膜脂肪层厚度(epicardial fat thickness,EFT)。比较3组患者PET的差异,并绘制受试者工作特征曲线。结果 ACS组EFT较SA组及对照组明显增厚(P<0.001),且SA组明显高于对照组(P<0.01)。以EFT≥3.25 mm作为诊断冠心病的标准,敏感度为73.4%,特异度为89.5%;以EFT≥3.35 mm作为诊断ACS的标准,敏感度为91.7%,特异度为68.1%。结论超声心动图测量心外膜脂肪层厚度是一种简便、无创预测冠心病和ACS的方法。Objective To determine the value of epicardial fat thickness （EFT） in predicting coronary heart disease （CHD）. Methods Eighty-three patients with suspected coronary artery disease underwent coronary angiography. According to the results of clinical diagnosis, the patients were divided into 3 groups ： acute coronary syndrome （ACS） group （ n = 36 ） , stable angina （SA） group （n = 28 ） and Control group （n = 19 ）. After acquiring left ventricle parasternal long axis view and apical four-chamber view of two-di- mension dynamic image, the EFT before the right ventricular anterior wall between incisura apex cordis and sulcus coronarius, behind the left ventricular posterior and nearby the incisura apex cordis were measured, respectively. The differences of EFT among three groups were compared, and the receiver operating characteristic curves were drawn. Results The EFT in the ACS group was much thicker than that in the SA group and the control group （ P 〈 0. 001 ）. The SA group had thicker EFT than the control group （ P 〈 0. 01 ）. The sensi- tivity was 73.4% and specificity was 89. 5% for detecting CHD when the EFT thicker than 3.25 mm was taken as cut-off value. The sensitivity was 91.7% and specificity was 68. 1% for detecting ACS when the EFT thicker than 3.35 mm was taken as cut-off value. Conclusion The measurement of EFT by echocardiography is a useful method for non-invasive prediction of CHD and ACS.

关 键 词：超声心动图 心外膜脂肪层 冠心病 急性冠脉综合征 稳定型心绞痛 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]