局部心外膜脂肪组织厚度联合中性粒细胞/淋巴细胞比值评价冠心病及其严重程度的价值  

Value of local epicardial adipose tissue thickness and neutrophil to lymphocyte ratio in the evaluation of coronary artery disease and its severity

作　　者：秦华丽 邢钰[1] 赵岩 邢军辉[1] 张文博[1] 李凌[1] QIN Huali;XING Yu;ZHAO Yan;XING Junhui;ZHANG Wenbo;LI Ling(Department of Cardiology, the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院心血管内科,郑州450052

出　　处：《郑州大学学报（医学版）》2019年第3期410-413,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省高等学校重点科研基金资助项目(16A320049);河南省医学科技攻关计划基金资助项目(201403026)

摘　　要：目的:探讨局部心外膜脂肪组织(EAT)厚度联合中性粒细胞/淋巴细胞比值(NLR)评价冠心病及其严重程度的临床价值。方法:回顾性分析292例拟诊冠心病患者的临床及实验室资料。患者均行经皮冠状动脉造影及心脏磁共振检查,根据造影结果,冠心病患者181例。比较冠心病和非冠心病患者的一般临床资料、血生化指标以及局部EAT厚度的差异。采用SYNTAX积分评价冠心病组患者冠脉病变严重程度。结果:①与非冠心病组相比,冠心病组各部分EAT厚度、NLR水平均较高(P <0. 05)。②Logistic回归分析显示,左侧房室沟EAT厚度、NLR水平是预测冠心病的指标,OR(95%CI)分别为1. 363(1. 195～1. 555)、1. 947(1. 480～2. 562)。③左侧房室沟EAT厚度、NLR、左侧房室沟EAT厚度联合NLR预测冠心病的ROC曲线下面积(95%CI)分别为0. 720 (0. 665～0. 771)、0. 801(0. 751～0. 846)、0. 825(0. 776～0. 967),两者联合的曲线下面积最大(P <0. 001)。④冠心病组患者左侧房室沟EAT厚度、NLR水平与SYNTAX积分呈正相关(r=0. 477和0. 439,P均<0. 001)。结论:左侧房室沟EAT厚度联合NLR可用于冠心病的预测和冠脉病变程度的评估。Aim:To evaluate the clinical value of local epicardial adipose tissue(EAT)thickness and neutrophil to lymphocyte ratio(NLR)in the evaluation of coronary artery disease(CAD)and its severity.Methods:The clinical and laboratory data of 292 patients who underwent percutaneous coronary angiography(CAG)and cardiac magnetic resonance imaging were collected.Based on CAG results,the patients were allocated into 2 groups:CAD group(n=181)and non-CAD group(n=111).The differences in clinical data,blood biochemical parameters and local EAT thickness were compared between the two groups.SYNTAX score was used to evaluate the severity of CAD.Results:Compared with non-CAD group,CAD group had increased levels of local EAT thickness and NLR(P<0.05).Logistic regression analysis showed that the EAT thickness in the left atrioventricular groove and NLR were indicators in the prediction of CAD,OR(95%CI)were 1.363(1.195-1.555)and 1.947(1.480-2.562).ROC curve showed that the AUC(95%CI)of the EAT thickness in the left atrioventricular groove,NLR,and the 2 indicators combination to predict CAD were 0.720(0.665-0.771),0.801(0.751-0.846),0.825(0.776-0.967),respectively.The AUC of the 2 indicators combination was the biggest(P<0.001).In CAD group,the EAT thickness in the left atrioventricular groove and NLR were significantly correlated with the SYNTAX score(r=0.477 and 0.439,P<0.001).Conclusion:The combination of EAT thickness in the left atrioventricular groove and NLR has high prediction value for CAD,which is positively correlated with the severity degree of CAD.

关 键 词：心外膜脂肪组织厚度 中性粒细胞/淋巴细胞比值 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]