心外膜脂肪组织对冠状动脉斑块分布的影响研究  

Relationship between epicardial adipose tissue and distribution of coronary plaque

作　　者：叶晨 唐礼江[1] 汤益民[1] 毛萍[1] 王江挺 杨家虎[2] 郭亦韬 刘小伟[1] YE Chen;TANG Lijiang;TANG Yimin;MAO Ping;WANG Jiangting;YANG Jiahu;GUO Yitao;LIU Xiaowei(Department of Cardiology,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院心内科,杭州310013 [2]浙江医院放射科,杭州310013

出　　处：《浙江医学》2021年第14期1537-1540,共4页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(LGJ18H020001);浙江省医药卫生科技计划面上项目(2019KY259)。

摘　　要：目的探讨心外膜脂肪组织(EAT)对冠状动脉斑块分布的影响。方法收集2015年1月至2018年8月在浙江医院冠状动脉造影后行血管内超声(IVUS)检查的34例患者影像资料。将同一血管、无分支汇入段、紧贴心包腔结构(血管中膜距心包腔≤1 mm),且斑块负荷最大帧影像归为组一,并依据毗邻心包腔的关系分为心包腔组(P组)和心肌面组(M组);非紧贴心包腔结构且斑块负荷最大帧影像归为组二,并依据毗邻心包腔的关系分为心包腔组(O组)和心肌面组(I组)。分别测定各组斑块面积。在冠状动脉计算机断层血管造影图像中血管相应位置,分别测量心包腔侧和心肌面侧的EAT厚度。结果组一中,P组斑块面积小于M组,差异有统计学意义(P<0.01);组二中,O组斑块面积与I组比较差异无统计学意义(P>0.05)。组一P组EAT厚度小于M组,差异有统计学意义(P<0.01),组二O组EAT厚度与I组比较差异无统计学意义(P>0.05)。结论冠状动脉无分支汇入段,斑块分布易受心外膜脂肪组织影响。Objective To analyze the relationship between epicardial adipose tissue(EAT)and the distribution of coronary artery plaques,using images and coronary CT angiography images.Methods The imaging data of 34 patients who underwent coronary CT angiography(CTA)and intravascular ultrasonography(IVUS)examination from January 2015 to August 2018 were retrospectively analyzed.The IVUS images of the coronary artery without branching segment and with the largest plaque burden,the intimate media of which was clinging to pericardial cavity(≤1 mm)were included in group 1(n=34),those not clinging to pericardial cavity were included in group 2(n=34).According to the relationship with the adjacent pericardial cavity group 1 and 2 were further divided into pericardial cavity group(group P)and myocardium group(group M),the plaque areas were measured and compared between the two groups.In corresponding positions on CTA images,the thickness of EAT on pericardial cavity surface and the myocardium surface were measured and compared.Results In group 1 the plaque area in group P was smaller than that in group M(P<0.01),while in group 2 there was no significant difference in plaque area between groups P and M(P>0.05).In group 1 the EAT thickness at the P side was smaller than that at the M side(P<0.01),which there was no significant difference in group 2(P>0.05).Conclusion The distribution of intravascular plaques in the non-branching segment of coronary artery is associated with the epicardial adipose tissue.

关 键 词：冠状动脉粥样硬化斑块 血管内超声 回顾性分析 心包腔 心外膜脂肪组织 

分 类 号：R541.4[医药卫生—心血管疾病]