心外膜脂肪厚度在冠心病诊断中的临床应用价值  

The clinical application value of epicardial fat thickness in the diagnosis of coronary heart disease

作　　者：肖建东[1] 张俊岭[1] 路玉李 张淑枝[1] 马星[2] 郑群[1] XIAO Jian-dong;ZHANG Jun-ling;LU Yu-li;ZHANG Shu-zhi;MA Xing;ZHENG Qun(Department of Cardiology,International Peace Hospital, Hengshui, Hebei 053000, China)

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超声科,衡水053000

出　　处：《中国循证心血管医学杂志》2017年第3期290-292,300,共4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：目的研究心外膜脂肪厚度在冠状动脉粥样硬化性心脏病(冠心病)患者诊断中的应用价值。方法选择150例冠心病患者,其中单支病变组、双支病变组、多支病变组各50例。另选择同期住院健康体检者50例作为对照组。所有入选者均采用超声心动图测定心外膜脂肪厚度,行冠状动脉造影检查判断冠状动脉狭窄程度。采用Person相关分析心外膜脂肪厚度与冠心病患者冠状动脉病变程度的相关性,采用受试者工作特征曲线(ROC)分析心外膜脂肪厚度对冠心病患者冠状动脉狭窄程度与数量的诊断价值。结果冠心病患者中,单支病变组、双支病变组、多支病变组患者的心外膜脂肪厚度均明显高于对照组(P均<0.01)。随冠心病严重程度的进展,心外膜脂肪厚度明显增加,二者呈正相关(r分别为0.412、0.352、0.542、0.593,P均<0.05)。ROC曲线分析显示,心外膜脂肪厚度对冠心病单支病变组、双支病变组、多支病变组患者诊断的AUC值分别为0.692、0.808、0.831。结论超声心动图测定的心外膜脂肪厚度与冠心病患者冠状动脉病变支数的程度相关,尤其对冠心病双支病变和多支病变患者具有较好的诊断价值。Objective To study the applied value of epicardial fat thickness in the diagnosis of coronary heart disease. Methods 150 patients with coronary heart disease were selected, including 50 patients in single vessel disease group, 50 patients in double vessel disease group and 50 patients in multi branch lesion group. 50 healthy volunteers were selected as control group. The thickness of epicardial fat was measured by echocardiography; coronary angiography was used to determine the extent of coronary stenosis; the correlation between epicardial fat thickness and coronary artery disease was analyzed using Person correlation; using the subject characteristic curve (ROC) to analyze the diagnostic value of epicardial fat thickness in the degree and quantity of coronary artery stenosis in patients with coronary heart disease. Results The epicardial fat thickness of single-vessel disease group, doublevessel disease group and multi-vessel disease group was significantly higher than that of control group (P<0.01).With the severity of coronary heart disease, epicardial fat thickness increased significantly, the two were positively correlated (r=0.412, 0.352, 0.542, 0.593, P<0.05). The AUC values of single-vessel disease group, double-vessel disease group and multi-vessel disease group were 0.692, 0.808 and 0.831 respectively. Conclusion Epicardial fat thickness is associated with the degree of coronary artery disease in patients with coronary heart disease, which has a good diagnostic value for patients with coronary artery disease and multiple coronary artery disease.

关 键 词：冠心病 心外膜脂肪厚度 冠状动脉造影 超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病]