CT评估老年缺血性心肌病心衰患者EAT、PCAT水平变化及与血清NT-proBNP、Gal-3表达的相关性  

CT evaluation of changes of EAT and PCAT levels in elderly patients with ischemic cardiomyopathy and heart failure and their correlation with expression of NT-proBNP and Gal-3 in serum

作　　者：李琰 郭洋洋 赵森[1] 杜森 周青[1] LI Yan;GUO Yangyang;ZHAO Sen;DU Sen;ZHOU Qing(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng,Henan 450052,China;Department of Medical Imaging,Kaifeng 155 Hospital,Kaifeng,Henan 475003,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封450052 [2]开封155医院医学影像科,河南开封475003

出　　处：《中国医学工程》2023年第10期19-23,共5页China Medical Engineering

基　　金：河南省卫健委科研项目(LHGJ20210565)。

摘　　要：目的探讨CT评估老年缺血性心肌病心力衰竭患者心外膜脂肪(EAT)、冠状动脉周围脂肪(PCAT)水平及与血清N末端脑钠肽前体(NT-proBNP)、半乳糖凝集素-3(Gal-3)表达的相关性。方法选取2020年1月至2022年1月在河南大学第一附属医院治疗的老年缺血性心肌病心力衰竭患者117例,其中心功能NYHA分级Ⅱ级31例,Ⅲ级44例,Ⅳ级42例;死亡患者29例,存活患者88例。比较不同患者EAT、PCAT及血清NT-proBNP、Gal-3水平差异。结果NYHA分级Ⅳ级患者EAT、PCAT、NT-proBNP和Gal-3分别为(97.29±15.56)cm^(3)、(20.20±5.01)cm^(3)、(460.20±95.56)pg/mL和(6.01±1.32)ng/mL,明显高于Ⅱ~Ⅲ级患者(P<0.05)。EAT、PCAT、NT-proBNP、Gal-3与NYHA分级呈正相关(rs=0.344、0.387、0.401和0.411,P<0.05);EAT与NT-proBNP、Gal-3呈正相关(r=0.411和0.426,P<0.05);PCAT与NT-proBNP、Gal-3呈正相关(r=0.424和0.403,P<0.05)。死亡患者EAT、PCAT、NT-proBNP和Gal-3分别为(100.44±17.20)cm^(3)、(20.85±3.02)cm^(3)、(456.42±78.30)pg/mL和(6.29±1.10)ng/mL,明显高于存活患者(P<0.05)。EAT、PCAT、NT-proBNP和Gal-3预测患者预后的受试者工作特征(ROC)曲线下面积分别为0.832、0.774、0.623和0.787(P<0.05)。结论老年缺血性心肌病心衰患者EAT、PCAT水平与血清NT-proBNP、Gal-3表达及心功能分级存在相关性,同时在预测患者预后方面有一定价值。【Objective】To investigate the relationship between the levels of epicardial adipose tissue(EAT),pericoronary adipose tissue(PCAT)and the expression of N-terminal pro brain natriuretic peptide(NT-proBNP)and galactose lectin-3(Gal-3)in serum in elderly patients with ischemic cardiomyopathy and heart failure.【Methods】From January 2020 to January 2022,117 elderly patients with ischemic cardiomyopathy and heart failure were treated in the First Affiliated Hospital of Henan University,including 31 patients with NYHA grade II,44 patients with NYHA grade III and 42 patients with NYHA grade IV;29 patients died and 88 survived.The levels of EAT,PCAT,NT-proBNP and Gal-3 in serum of different patients were compared.【Results】The EAT,PCAT,NT-proBNP and Gal-3 of NYHA grade IV patients were 97.29±15.56 cm^(3),20.20±5.01 cm^(3),460.20±95.56 pg/mL and 6.01±1.32 ng/mL,respectively,which were significantly higher than those of grade II to III patients(P<0.05).EAT,PCAT,NT-proBNP,Gal-3 were positively correlated with NYHA classification(rs=0.344,0.387,0.401 and 0.411,P<0.05).EAT was positively correlated with NT-proBNP and Gal-3(r=0.411 and 0.426,P<0.05).PCAT was positively correlated with NT-proBNP and Gal-3(r=0.424 and 0.403,P<0.05).EAT,PCAT,NT-proBNP and Gal-3 in the dead patients were 100.44±17.20 cm^(3),20.85±3.02 cm^(3),456.42±78.30 pg/mL and 6.29±1.10 ng/mL,respectively,which were significantly higher than those survived patients(P<0.05).The areas under ROC curve of EAT,PCAT,NT-proBNP and Gal-3 to predict the prognosis of patients were 0.832,0.774,0.623 and 0.787,respectively(P<0.05).【Conclusion】The levels of EAT and PCAT in elderly patients with heart failure caused by ischemic cardiomyopathy are correlated with the expression of NT-proBNP and Gal-3 in serum and the grade of cardiac function,and have certain value in predicting the prognosis of patients.

关 键 词：缺血性心肌病 心力衰竭 老年 心外膜脂肪 冠状动脉周围脂肪 N末端脑钠肽前体 半乳糖凝集素-3 

分 类 号：R541[医药卫生—心血管疾病]