心外膜脂肪组织厚度及血清小而密的低密度脂蛋白水平对冠心病的诊断价值  

Diagnostic Value of Epicardial Adipose Tissue Thickness and Serum Small and Dense Low Density Lipoprotein Level for Coronary Heart Disease

作　　者：琚炜 张平洋[1] 胡庆兰 李妙[1] JU Wei;ZHANG Pingyang;HU Qinglan;LI Miao(Cardiovascular Ultrasound Department,Nanjing Medical University Affiliated Nanjing Hospital/Nanjing First Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院心血管超声科,210000江苏省南京市 [2]安徽省皖南康复医院超声医学科,安徽省芜湖市241000

出　　处：《实用心脑肺血管病杂志》2023年第9期33-36,41,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省卫生健康委科研重点项目(ZD2021048)。

摘　　要：目的探讨心外膜脂肪组织(EAT)厚度及血清小而密的低密度脂蛋白(sd-LDL)水平对冠心病的诊断价值。方法选取2020年6月至2022年6月南京医科大学附属南京医院收治的冠心病患者90例,根据冠状动脉造影(CAG)检查结果将患者分为轻度组(20例)、中度组(38例)和重度组(32例);另选取同期在本院体检的健康者40例作为对照组。比较四组EAT厚度、血清sd-LDL水平,采用Pearson相关分析探讨EAT厚度、血清sd-LDL水平与冠心病患者冠状动脉狭窄率的相关性;绘制ROC曲线以评估EAT厚度、血清sd-LDL水平及二者联合诊断冠心病的价值。结果轻度组、中度组及重度组EAT厚度、血清sd-LDL水平高于对照组,中度组、重度组EAT厚度、血清sd-LDL水平高于轻度组,重度组EAT厚度、血清sd-LDL水平高于中度组(P<0.05)。Pearson相关分析结果显示,EAT厚度、血清sd-LDL水平与冠心病患者冠状动脉狭窄率呈正相关(r=0.336,P<0.01;r=0.401,P<0.01)。ROC曲线分析结果显示,EAT厚度、血清sd-LDL水平诊断冠心病的曲线下面积分别为0.827[95%CI(0.708,0.913)]、0.878[95%CI(0.767,0.948)],二者联合诊断冠心病的曲线下面积为0.927[95%CI(0.830,0.978)]。结论冠心病患者EAT厚度增厚、血清sd-LDL水平升高,且EAT厚度、血清sd-LDL水平与冠状动脉狭窄率呈正相关,二者联合对冠心病有较高诊断价值。Objective To investigate the diagnostic value of epicardial adipose tissue(EAT)thickness and serum small and dense low density lipoprotein(sd-LDL)level for coronary heart disease.Methods A total of 90 coronary heart disease patients who admitted to the Nanjing Medical University Affiliated Nanjing Hospital from June 2020 to June 2022 were selected and divided into mild group(20 cases),moderate group(38 cases)and severe group(32 cases)according to the results of coronarography(CAG).Another 40 healthy individuals who underwent physical examination during the same period at the same hospital were selected as the control group.EAT thickness and serum sd-LDL level were compared among four groups.Pearson correlation analysis was used to analyze the correlation between EAT thickness,serum sd-LDL level and coronary artery stenosis rate in patients with coronary heart disease.ROC curve was used to analyze the value of EAT thickness,serum sd-LDL level and their combination in diagnosing coronary heart disease.Results The EAT thickness and serum sd-LDL level in the mild group,moderate group and severe group were higher than those in the control group,the EAT thickness and serum sd-LDL level in the moderate group and severe group were higher than those in the mild group,the EAT thickness and serum sd-LDL level in the severe group were higher than those in the moderate group(P<0.05).The results of Pearson correlation analysis showed EAT thickness,serum sd-LDL level were positively correlated with coronary artery stenosis rate in patients with coronary heart disease(r=0.336,P<0.01;r=0.401,P<0.01).The results of ROC curve analysis showed that the AUC of EAT thickness and serum sd-LDL level in diagnosing coronary heart disease was 0.827[95%CI(0.708,0.913)]and 0.878[95%CI(0.767,0.948)]respectively,and the AUC of their combination in diagnosing coronary heart disease was 0.927[95%CI(0.830,0.978)].Conclusion EAT thickness and serum sd-LDL level increase in patients with coronary heart disease.EAT thickness and serum sd-LDL level ar

关 键 词：冠心病 心外膜脂肪组织厚度 小而密的低密度脂蛋白 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]