256层螺旋CT测量心脏周围脂肪体积与冠心病的相关性研究  

Correlation between pericardial adipose tissue volume and coronary heart disease measured by 256-slice spiral CT

作　　者：翁静飞 何宇情 杨彬 何其舟 代平 姚丁华 余飞 曾奇虎 WENG Jing-fei;HE Yu-qing;YANG Bin;HE Qi-zhou;DAI Ping;YAO Ding-hua;YU Fei;ZENG Qi-hu(Department of Radiology,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan,CHINA;Department of Cardiology,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan,CHINA)

机构地区：[1]西南医科大学附属中医医院放射科,四川泸州646000 [2]西南医科大学附属中医医院心内科,四川泸州646000

出　　处：《海南医学》2022年第7期906-909,共4页Hainan Medical Journal

基　　金：西南医科大学-西南医科大学附属中医医院联合项目(编号:2020XYLH-088)。

摘　　要：目的探讨256层螺旋CT定量研究心脏周围脂肪体积与冠心病相关性研究。方法随机选取西南医科大学附属中医医院2017年1月至2019年12月行CT冠脉成像的200例患者,所有患者均在短期内进行冠脉动脉造影检查,以冠脉动脉造影检查结果为金标准,将152例冠心病纳入冠心病,余48例纳入对照组。在后处理机器上测量两组患者的心脏周围脂肪体积(包括心周脂肪体积、心外膜脂肪体积、心包膜外脂肪体积),采用受试者工作特征曲线(ROC),Spearman相关性分析及二元Logistic回归模型分析各指标与冠心病相关性。结果冠心病组患者的年龄、男性占比、高血压、糖尿病、空腹血糖、甘油三酯、低密度脂蛋白、肌酐、尿酸、白细胞计数、心外膜脂肪体积、心周总脂肪体积明显高于对照组,差异均有统计学意义(P<0.05);心外膜脂肪体积诊断冠心病ROC曲线下面积为0.791,诊断阈值为183.61 m L,敏感度为83.3%,特异性为61.8%;心外膜脂肪体积和心周总脂肪体积与冠心病呈正相关(r=0.516、0.431,P<0.05),但前者相关性高于后者;经二元Logistic回归分析显示心周脂肪体积是冠心病发生的独立危险因素(P<0.05)。结论心周脂肪体积和心外膜脂肪体积与冠心病呈正相关性,对冠心病的诊断有一定帮助,并且心周脂肪体积为冠心病发生的独立危险因素。Objective To investigate the relationship between pericardial adipose tissue volume measured by256-slice spiral CT and coronary heart disease.Methods A total of 200 patients with suspected coronary heart disease underwent CT coronary imaging in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2017 to December 2019 were randomly selected.All patients underwent coronary angiography in a short term,and the results of coronary angiography were used as the gold standard.The 152 patients with coronary heart disease were identified as coronary heart disease group,and remaining 48 patients were included the control group.The pericardial fat volume(including pericardial adipose tissue volume,epicardial adipose tissue volume,paracardial adipose tissue volume)were measured by 3D postprocessing workstation.ROC curve,Spearman correlation analysis,and binary logistic regression model were used to analyze the correlation between each index and coronary heart disease.Results The age,male proportion,hypertension,diabetes,fasting blood glucose,triglyceride,low density lipoprotein,creatinine,uric acid,white blood cell count,epicardial adipose tissue volume,total pericardial adipose tissue volume of patients in the coronary heart disease group were significantly higher than those in the control group(P<0.05).The area under the ROC curve of diagnostic CAD was 0.791,with a diagnostic threshold of 183.61 m L,a sensitivity of 83.3%,and a specificity of 61.8%.Epicardial adipose tissue volume and total pericardial adipose tissue volume were positively correlated with coronary heart disease(r=0.516,0.431,P<0.05),but the former was higher than the latter.Binary logistic regression analysis showed that pericardial adipose tissue volume was an independent risk factor for coronary heart disease.Conclusion Pericardial adipose tissue volume and epicardial adipose tissue volume are helpful for the diagnosis of coronary heart disease,and the pericardial adipose tissue volume is an independent risk f

关 键 词：心周脂肪体积 心外膜脂肪体积 心包膜外脂肪体积 冠心病 诊断 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]