超声评价中老年冠心病患者心外膜脂肪层厚度与颈动脉血管弹性的相关性  

The correlation between epicardial adipose thickness and elasticity of carotid artery in middle-aged and elderly patients with coronary heart disease by ultrasonography

作　　者：郭兴[1] 李金生[1] 王星[2] GUO Xing;LI Jinsheng;WANG Xing(Department of Ultrasound,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Cardiology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院超声科,河南省南阳市473000 [2]南阳市中心医院心内科,河南省南阳市473000

出　　处：《中国动脉硬化杂志》2023年第9期785-790,共6页Chinese Journal of Arteriosclerosis

基　　金：河南省医学科技攻关联合共建项目(LHGJ20221049)。

摘　　要：[目的]探究超声评价中老年冠心病(CHD)患者心外膜脂肪层厚度(EAT)与右侧颈总动脉弹性及其内膜中膜厚度(CIMT)的相关性。[方法]选择2018年2月—2021年6月于南阳市中心医院就诊且经冠状动脉造影(CAG)确诊为CHD的中老年患者(100例)为研究对象,根据病变支数,分为单支(31例)、双支(36例)和三支病变组(33例);另选取同期于南阳市中心医院进行体检的无CHD者(50例)作为对照组。对比分析四组受试者的一般资料以及超声检测参数。通过Pearson分析EAT与右侧颈总动脉弹性、CIMT的相关性。应用受试者工作特征(ROC)曲线分析EAT、右侧颈总动脉弹性和CIMT预测CHD的价值。[结果]与对照组相比,单支、双支及三支病变组的血管僵硬度(β)、弹性模量(Ep)、脉搏波传导速度(PWV-β)、CIMT和EAT均显著增加(均P<0.05),顺应性(AC)显著降低(均P<0.05)。Pearson分析结果显示,EAT与β、Ep、PWV-β及CIMT均呈正相关(P<0.05),与AC呈负相关(P<0.05)。ROC曲线分析结果显示,EAT、CIMT以及右侧颈总动脉弹性三者联合预测CHD发生的灵敏度、特异度和Youden指数分别为89%、82%和71%。[结论]中老年CHD患者的EAT与右侧颈总动脉弹性变化、CIMT均具有良好相关性;EAT与右侧颈总动脉弹性变化以及CIMT联合检测可为临床预测CHD提供较好的依据。Aim To explore the correlation between ultrasound evaluation of epicardial adipose thickness(EAT)and right common carotid artery elasticity and carotid intima-media thickness(CIMT)in middle-aged and elderly coronary heart disease(CHD)patients.Methods The middle-aged and elderly patients(100 cases)who visited Nanyang Central Hospital from February 2018 to June 2021 and were diagnosed with CHD by coronary angiography(CAG)were selected as the research subjects.According to the number of diseased branches,they were divided into single(31 cases),double(36 cases)and triple(33 cases)vessel lesions groups.In addition,physical examination population without coronary heart disease(50 cases)at Nanyang Central Hospital during the same period were selected as the control group.The general information and ultrasonic testing parameters of the four groups of subjects were compared and analyzed.Pearson was used to analyze the correlation between EAT and the elasticity of the right common carotid artery,CIMT.The receiver operating characteristic(ROC)curve was used to analyze the value of EAT,right common carotid artery elasticity and CIMT in predicting CHD.Results Compared with the control group,vascular stiffness(β),elastic modulus(Ep),pulse wave velocity(PWV-β),CIMT,and EAT were increased in the single vessel lesion group,double vessel lesions group,and triple vessel lesions group(all P<0.05),aortic compliance(AC)were decreased(all P<0.05).Pearson analysis showed that EAT was positively correlated withβ,Ep,PWV-βand CIMT(P<0.05),and negatively correlated with AC(P<0.05).The results of ROC curve analysis showed that the sensitivity,specificity and Youden index of the three combined detection(EAT,CIMT and right common carotid artery elasticity)were 89%,82%and 71%in predicting the occurrence of CHD,respectively.Conclusion EAT in middle-aged and elderly patients with CHD has a good correlation with the elastic changes of the right common carotid artery,CIMT.The combined detection of EAT,right common carotid artery elasticity chan

关 键 词：冠心病 超声 心外膜脂肪层厚度 颈动脉 血管弹性 颈动脉内膜中膜厚度 

分 类 号：R5[医药卫生—内科学]