冠状动脉周围脂肪组织脂肪衰减系数的影响因素及其回归模型  

Influencing factors and regression model of the fat attenuation index of pericoronary adipose tissue

作　　者：王弘宇 王腾玉[1] 尹德春[1] 田野[1] WANG Hongyu;WANG Tengyu;YIN Dechun;TIAN Ye(Department of Cardiology,the First Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,黑龙江省哈尔滨市150001

出　　处：《中国动脉硬化杂志》2023年第5期411-418,共8页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(81727809)。

摘　　要：[目的]探究冠状动脉局部无炎症或轻度炎症时冠状动脉周围脂肪组织(PCAT)的脂肪衰减系数(FAI-PCAT)的影响因素并建立可预测其基础值的回归模型。[方法]入选哈尔滨医科大学附属第一医院2019年1月—12月既往无冠心病病史、行冠状动脉计算机断层扫描血管造影(CCTA)检查排除梗阻性冠状动脉疾病的住院患者。收集患者基线资料和临床指标包括性别、年龄、身高、体质量、既往病史以及血常规、血糖、血脂等。由一名具有3年以上影像学阅片经验的医师应用AW VolumeShare 4 CT工作软件进行CCTA图像后处理,测量并记录FAI-PCAT值和心外膜脂肪衰减(EFat值)。采用Spearman相关性检验分析各因素相关性,采用多元线性回归分析FAI-PCAT的影响因素并建立回归模型。[结果]共纳入103例CCTA显示CAD-RADS 0~1级的患者。FAI-PCAT值为(-82.2±7.0)Hu,EFat值为(-84.8±4.4)Hu。相关性分析显示FAI-PCAT值与EFat值呈显著正相关(P<0.01),与淋巴细胞/单核细胞比值(LMR)、淋巴细胞百分比呈显著负相关(P<0.01),与血糖水平呈正相关(P<0.05),与体质指数(BMI)、血脂各项指标不具有相关性;EFat值与BMI、甘油三酯(TG)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(LDLC/HDLC)、极低密度脂蛋白胆固醇(VLDLC)水平呈显著负相关(P<0.01),与HDLC呈显著正相关(P<0.01),与载脂蛋白A/载脂蛋白B比值(ApoA/ApoB)呈正相关(P<0.05)。多元线性回归分析显示EFat值(X 1)、LMR(X 2)和血糖水平(X 3)是冠状动脉局部无炎症或轻度炎症时FAI-PCAT值(■)的主要影响因素和预测参数,回归方程为■=-25.466+0.686X_(1)-0.9X_(2)+1.207X_(3)。[结论]冠状动脉局部无炎症或轻度炎症时EFat值、LMR和血糖水平是影响FAI-PCAT值的主要因素,回归模型可预测患者个体化的FAI-PCAT基础值。Aim To explore the influencing factors of fat attenuation index of pericoronary adipose tissue(FAI-PCAT)when there is no local inflammation or mild inflammation of coronary artery,and to establish a regression model to predict the individual baseline values of FAI-PCAT.Methods Hospitalized patients who had no previous history of coronary heart disease and underwent coronary computed tomography angiography(CCTA)examination to exclude obstructive coronary artery disease in the First Affiliated Hospital of Harbin Medical University from January to December 2019 were included.The baseline data and clinical indexes such as sex,age,height,weight,past medical history,blood routine,blood glucose,and blood lipid were collected.The AW VolumeShare 4 CT working software was used to post-process the CCTA images by one doctor with more than 3 years of imaging experience,and FAI-PCAT and epicardial fat attenuation(EFat)were measured and recorded.Spearman correlation was used to analyze the correlation of factors.Multiple linear regression was used to analyze the influencing factors of FAI-PCAT and then established a regression model.Results A total of 103 patients with CCTA showing CAD-RADS 0~1 were included.The FAI-PCAT value is(-82.2±7.0)Hu,the EFat value is(-84.8±4.4)Hu.Correlation analysis showed that FAI-PCAT was significantly and positively correlated with EFat(P<0.01),significantly and negatively correlated with lymphocyte to monocyte ratio(LMR),lymphocyte percentage(P<0.01),and positively correlated with blood glucose level(P<0.05).There was no correlation between FAI-PCAT and body mass index(BMI),blood lipid.The EFat was significantly and negatively correlated with BMI,triglyceride(TG),low density lipoprotein cholesterol/high density lipoprotein cholesterol(LDLC/HDLC),very low density lipoprotein cholesterol(VLDLC)(P<0.01),and significantly and positively correlated with HDLC(P<0.01),positively correlated with apolipoprotein A/apolipoprotein B(ApoA/ApoB)(P<0.05).Multiple linear regression analysis showed that EFat va

关 键 词：冠状动脉周围脂肪组织 脂肪衰减系数 心外膜脂肪衰减 冠状动脉计算机断层扫描血管造影 回归模型 

分 类 号：R5[医药卫生—内科学]