320排CT心外膜脂肪体积和冠脉钙化积分与冠状动脉狭窄的关系  

Correlation of epicardial adipose volume and coronary calcification score with coronary stenosis in 320-row CT

作　　者：高强[1] 邓克学 程好堂 GAO Qiang;DENG Kexue;CHENG Haotang(CT Magnetic Resonance Room,Taihe County Hospital of Traditional Chinese Medicine,Anhui Province,Fuyang236600,China;Department of Imaging,the First Affiliated Hospital of University of Science and Technology of China,Anhui Province,Hefei230001,China)

机构地区：[1]安徽省太和县中医院CT磁共振室,安徽阜阳236600 [2]中国科学技术大学附属第一医院影像科,安徽合肥230001

出　　处：《中国医药导报》2020年第26期41-44,52,共5页China Medical Herald

基　　金：安徽省太和县科技计划基金项目(太科【2017】60号007)。

摘　　要：目的探讨320排CT心外膜脂肪体积(EATV)和冠脉钙化积分(CACS)与冠状动脉狭窄的关系。方法选取2017年10月—2019年4月于安徽省太和县中医院接受320排CT检查的冠心病患者200例作为冠心病组,同时选取接受320排CT检查且未发现冠状动脉狭窄者40例作为对照组。采用Gensini积分系统将冠心病组患者分为低分组(Gensini评分<41分,85例)、中分组(41分≤Gensini评分<64分,65例)及高分组(Gensini评分≥64分,50例)。记录并比较各组EATV及CACS。结果冠心病组EATV及CACS均高于对照组,差异有统计学意义(P<0.05)。3亚组EATV及CACS比较差异有统计学意义(P<0.05)。高分组EATV及CACS均高于低分组和中分组,中分组EATV及CACS均高于低分组,差异有统计学意义(P<0.05)。EATV与CACS、病变血管支数、Gensini评分呈正相关(r=0.332、0.421、0.451,P<0.05),CACS与病变血管支数、Gensini评分呈正相关(r=0.359、0.436,P<0.05)。EATV预测冠状动脉高分患者的曲线下面积(AUC)为0.75(P<0.05),特异度为65.2%,灵敏度为84.2%,截断值为191.25 cm3;CACS的AUC为0.75,特异度为61.8%,灵敏度为88.3%,截断值为286.05分。结论320排CT EATV及CACS与冠心病患者冠状动脉狭窄呈正相关,且对预测重度冠状动脉狭窄具有一定价值。Objective To investigate the relationship between epicardial adipose tissue volume(EATV)measurement and coronary calcification score(CACS)with coronary stenosis in 320-row CT.Methods A total of 200 patients with coronary heart disease underwent 320-row CT examination at Taihe County Traditional Chinese Medicine Hospital of Anhui Province from October 2017 to April 2019 were selected as coronary heart disease group,and 40 patients underwent 320-row CT examination without coronary artery stenosis were selected as control group.The patients in coronary heart disease group were divided into low score group(Gensini score<41 points,85 cases),middle score group(41 points≤Gensini score<64 points,65 cases),and high score group(Gensini score≥64 points,50 cases)according Gensini score system.EATV and CACS of each group were recorded and compared.Results EATV and CACS in coronary heart disease group were higher than those in control group,the differences were statistically significant(P<0.05).There were significant differences in EATV and CACS among three subgroups(P<0.05).EATV and CACS in high score group were higher than those in low score group and middle score group,while EATV and CACS in middle score group were higher than those in low score group,the differences were statistically significant(P<0.05).EATV was positively correlated with CACS,number of diseased vessels and Gensini score(r=0.332,0.421,0.451,P<0.05).CACS was positively correlated with the number of vessels and Gensini score(r=0.359,0.436,P<0.05).The area under curve(AUC)of EATV was 0.75(P<0.05),the specificity was 65.2%,the sensitivity was 84.2%,and the cut-off value was 191.25 cm3.AUC of CACS was 0.75,the specificity was 61.8%,the sensitivity was 88.3%,and the cut-off value was 286.05 points.Conclusion The 320-row CT EATV and CACS are positively correlated with coronary artery stenosis in patients with coronary heart disease,and have certain value in predicting severe coronary artery stenosis.

关 键 词：320排CT 心外膜脂肪体积 冠脉钙化积分 冠状动脉狭窄 

分 类 号：R543[医药卫生—心血管疾病]