心外膜脂肪组织体积和密度与冠状动脉斑块及狭窄的相关性  

Correlation of epicardial adipose tissue volume and density with coronary artery plaques and stenosis in patients with coronary heart disease

作　　者：冯晓阳 高志红[2] 孟园园 魏炜 高子梅 FENG Xiaoyang;GAO Zhihong;MENG Yuanyuan(Imaging Center,Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市人民医院影像中心,050000 [2]河北医科大学第二医院体检中心

出　　处：《河北医药》2023年第22期3427-3431,3436,共6页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20230519)。

摘　　要：目的探讨冠心病(coronary heart disease,CHD)患者心外膜脂肪组织体积(Epicardial adipose tissue volume,EATV)和心外膜脂肪组织密度(Epicardial adipose tissue density,EATD)对冠脉斑块影响及与冠脉狭窄的相关性。方法收集2018年9月至2019年9月在我院住院确诊为CHD患者240例,所有患者行冠状动脉CT血管造影(coronary computed tomographic angiography,CCTA)检查,根据CCTA结果将受试者分为高危斑块(high-risk plaque,HRP)组133例,非高危斑块(Non-high-risk plaque,NHRP)组107例,分析CHD患者EATV及EATD对冠状动脉斑块的影响及与冠状动脉狭窄程度之间的相关性。结果HRP组EATV、EATD、年龄高于NHRP组,差异均有统计学意义(P<0.05),校正其他危险因素后,多因素回归分析发现EATV及EATD仍然是CHD患者高危斑块的预测因子(P<0.05)。ROC曲线示EATD较EATV对HRP有更高的预测价值[AUC 0.761,敏感性62.4%,特异性为84.1%,95%CI(0.701~0.822)]。Spearman相关性分析发现EATV与Gensini积分呈正相关(R=0.667,P<0.05);EATD与Gensini积分间无相关性(R=0.060,P>0.05)。结论CHD患者EATD及EATV是冠状动脉HRP的预测因子,EATD有望成为预测HRP新指标;CHD患者冠状动脉狭窄程度与EATV呈正相关,而与EATD无相关性。Objective To study the influence of epicardial adipose tissue volume(EATV)and density(EATD)on coronary artery plaques,and their correlation with coronary artery stenosis in patients with coronary heart disease(CHD).Methods A total of 240 hospitalized patients diagnosed with CHD in our hospital from September 2018 to September 2019 were recruited.All patients underwent coronary computed tomographic angiography(CCTA).According to CCTA findings,CHD patients were divided into the high-risk plaque(HRP)group(133 patients)and non-high-risk plaque(NHRP)group(107 patients).The influence of EATV and density EATD on coronary artery plaques,and their correlation with coronary artery stenosis in CHD patients were analyzed.Results The age,EATV and EATD were significantly higher in HRP group than those of NHRP group(P<0.05).After adjustment for other risk factors,multivariate logistic regression analysis found that EATV and EATD were still predictors for HRP in CHD patients(P<0.05).The receiver operating characteristics(ROC)curves showed that EATD had a higher potential in predicting HRP than that of EATV,with the area under the curve(AUC),sensitivity,and specificity of 0.761(95%CI:0.701,0.822),62.4%and 84.1%,respectively.Spearman correlation analysis showed that EATV was positively correlated with the Gensini score(R=0.667,P<0.05).There was no significant linear correlation between EATD and Gensini score(R=0.060,P>0.05).Conclusion EATD and EATV are predictors for HRP in CHD patients,and EATD is expected to be a novel factor for predicting HRP.The degree of coronary stenosis in CHD patients is positively correlated with EATV,but not correlated with EATD.

关 键 词：计算机断层摄影术 冠心病 心外膜脂肪组织 高危斑块 

分 类 号：R541.4[医药卫生—心血管疾病]