冠状动脉周围脂肪CT值与斑块性质及所在分支的相关性研究  

Correlation Study of CT Values of Pericoronary Adipose Tissue with Plaque Properties and Coronary Artery Branches

作　　者：丁如 孔丹 冯云[1] 庄莹莹 郭莉莉[1] DING Ru;KONG Dan;FENG Yun(The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian,Anhui Province 223300,P.R.China)

机构地区：[1]南京医科大学附属淮安第一医院,淮安223300

出　　处：《临床放射学杂志》2022年第5期850-855,共6页Journal of Clinical Radiology

摘　　要：目的探讨分析冠状动脉周围脂肪(PCAT)CT值与斑块性质及所在分支的相关性。方法通过冠状动脉CTA检查,入组管腔轻-中度狭窄的患者178例(疾病组),管腔无狭窄的106例(对照组),测量疾病组中不同冠状动脉分支中、不同性质斑块与同支正常区域的PCAT的CT值,并测量所有病例的心外膜脂肪(EAT)及左胸壁皮下脂肪CT值。结果疾病组较对照组平均年龄大,平均心率快,高血压的发生率高,EAT及左胸壁皮下脂肪CT值较高(P<0.05)。对比各性质斑块、各冠状动脉分支斑块与同支正常区域PCAT的CT值,发现部分钙化、非钙化斑块PCAT的CT值对比正常差异有统计学意义(P<0.05)。右冠状动脉(RCA)斑块、左主干-左前降支(LM-LAD)斑块PCAT的CT值对比正常差异有统计学意义(P<0.05)。分析斑块性质及冠状动脉分支部位对斑块PCAT的CT值的影响,发现钙化斑块PCAT的CT值较部分钙化及非钙化斑块PCAT的CT值低,且差异有统计学意义(P<0.05),而冠状动脉分支部位对斑块PCAT的CT值无明显影响(F=0.603,P=0.548)。结论PCAT、EAT及左胸壁皮下脂肪CT值与冠状动脉粥样硬化的斑块性质存在相关性,一定程度上对心血管病的诊断及预后有潜在的预测价值。Objective To explore and analyze the correlation between CT values of pericoronary adipose tissue with plaque properties and coronary artery branches.Methods Through coronary CTA examination,178 patients with mild to moderate lumen stenosis were enrolled in the disease group,and 106 patients without lumen stenosis were enrolled in the control group.The CT values of the pericoronary adipose tissue(PCAT)of different plaques,different coronary artery branches and the PCAT of the normal vessels in the same vessel were measured,the CT values of epicardial adipose tissue(EAT)and left chest wall subcutaneous fat were measured concurrently in all cases.Results People in disease group were older than those in control,with a faster average heart rate,a higher incidence of hypertension,and higher CT values of EAT and left chest wall subcutaneous fat(P<0.05).Comparing the CT values of PCAT surrounding plaques with various properties,different coronary artery branches and the PCAT of corresponding normal arteries,there were statistically significant differences between the CT values of PCAT surrounding partially calcified plaques,non calcified plaques and the normal(P<0.05).The CT values of PCAT surrounding plaques of RCA and LM LAD were significantly different from the normal(P<0.05).Based on the analysis of the effects of plaque properties and coronary artery branches on the CT values of PCAT,it was found that the average CT value of calcified plaque PCAT was lower than that of partially calcified plaques and non-calcified plaques,and the difference was statistically significant(P<0.05),while the location of coronary artery branches had no significant effect on the CT values of PCAT surrounding with plaques(F=0.603,P=0.548>0.05).Conclusion The CT values of PCAT,EAT and left chest wall subcutaneous fat are correlated with the plaque properties of the coronary atherosclerosis,which have a potential predictive value for the diagnosis and prognosis of cardiovascular diseases to some extent.

关 键 词：冠状动脉粥样硬化 狭窄 斑块 心外膜脂肪组织 体层摄影术 X线计算机 

分 类 号：R541.4[医药卫生—心血管疾病]