心外膜脂肪组织与经皮冠状动脉介入治疗相关短期并发症的关系  

The relationship between epicardial adipose tissue and short-term complications for patients with percutaneous coronary intervention

作　　者：侯小玲[1] 付振虹[1] 单冬凯[1] 张威[1] 陈韵岱[1] HOU Xiao-ling;FU Zhen-hong;SHAN Dong-kai;ZHANG Wei;CHEN Yun-dai(Department of Cardiology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心心内科,北京100853

出　　处：《中国介入心脏病学杂志》2020年第5期241-246,共6页Chinese Journal of Interventional Cardiology

基　　金：国家重点研发计划项目课题(2016YFC1300304);领航基金课题项目(LHJJ201611827)。

摘　　要：目的探讨心外膜脂肪组织(EAT)与冠心病患者经皮冠状动脉介入治疗(PCI)相关短期并发症的关系。方法回顾性分析解放军总医院第一医学中心心内科自2014年1月至12月209例术前已行冠状动脉CT血管造影的冠心病患者的PCI手术相关临床资料,测定EAT体积并分析术中及术后30 d内发生的短期并发症,对可能影响并发症的因素进行分析。结果209例患者PCI术前的EAT体积为(129.3±49.7)ml,有18例(8.6%)患者发生短期并发症,包括:10例(4.8%)冠状动脉夹层,其中1例合并术中冠状动脉穿孔,1例合并术后出血;6例(2.9%)出血;2例(1.0%)心肌梗死,其中1例合并心原性休克;1例脑梗死。单因素分析发现,高血压病、EAT体积大(>130 ml)、多支病变、置入支架数量多的患者,PCI术中及术后短期并发症发生率显著增高(均P<0.05)。logistic多因素分析显示,EAT体积大(>130 ml)(OR 4.268,95%CI 1.422~12.812,P=0.010)和多支病变(OR 5.113,95%CI 1.786~14.638,P=0.002)是PCI术后并发症的独立危险因素。结论EAT体积大(>130 ml)是PCI相关短期并发症的独立危险因素。术前测定EAT可能对PCI术中及术后短期并发症的预测具有一定的价值。Objective To investigate the relationship between epicardial adipose tissue and short-term complications for patients with percutaneous coronary intervention(PCI).Methods Patients with obstructive coronary artery disease undergoing multi-sclice CT and PCI during January to December 2014 in the First Medical Center of Chinese PLA General Hospital were retrospectively enrolled in this study.Patients’EAT volume were calculated and complications in the 30 days during and after PCI were collected.Univariate and multivariate analysis were conducted to assess the predictors associated with short-term complications.Results A total of 209 cases were enrolled and 18(8.6%)cases had shortterm complications,10(4.8%)cases of coronary artery dissection,including 1 with intraoperative coronary artery perforation and 1 case with postoperative bleeding,6(2.9%)cases of bleeding,2(1.0%)cases of myocardial infarction,inclouding 1 case with cardiogenic shock,and 1 case of cerebral infarction.The mean EAT volume was(129.3±49.7)ml.Univariate analysis showed that patients with hypertension,high EAT volume(>130 ml),multiple lesions or more stent implantation had signifi cantly increased incidence of short-term complications(All P<0.05).Multivariate logistics analysis demonstrated that high EAT volume(>130 ml)and multiple lesions were the independent predictive factors(OR 4.628,95%CI 1.422–12.812,P=0.010 and OR 5.113,95%CI 1.786–14.638,P=0.002).Conclusions High EAT volume(>130 ml)was an independent predictive factor associated with short-term complications for patients with percutaneous coronary intervention.

关 键 词：心外膜脂肪 经皮冠状动脉介入治疗 并发症 预测因素 

分 类 号：R542.2[医药卫生—心血管疾病]