中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
6期
1045-1050
,共6页
陈栋%宫剑滨%朱飞鹏%张启高%程训民%杭涛%王璟
陳棟%宮劍濱%硃飛鵬%張啟高%程訓民%杭濤%王璟
진동%궁검빈%주비붕%장계고%정훈민%항도%왕경
脂肪组织%冠状动脉疾病%动脉粥样硬化%体层摄影术
脂肪組織%冠狀動脈疾病%動脈粥樣硬化%體層攝影術
지방조직%관상동맥질병%동맥죽양경화%체층섭영술
Adipose tissue%Coronary artery disease%Atherosclerosis%Tomography
目的:探讨冠心病患者心外膜脂肪体积对冠状动脉斑块稳定性的影响。方法纳入同期行双源CT冠状动脉成像与经皮冠状动脉造影的冠心病患者145例,测量患者的身高、体重、血压、血生化指标,通过64排双源CT测定心外膜脂肪体积与斑块性质、重构指数、点状钙化,并进行心外膜脂肪体积与易损斑块的相关分析。结果年龄、性别、吸烟、糖尿病、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)在斑块性质、血管重构、点状钙化中的差异均无统计学意义(P>0.05)。LDL-C在斑块性质与点状钙化中也无统计学差异(P>0.05),正性重构组 LDL-C 水平高于非正性重构组(P=0.040)。非钙化斑块组、正性重构组、点状钙化组的高血压患病率、BMI与心外膜脂肪体积均高于钙化斑块组、非正性重构组、无点状钙化组(P<0.05),其中心外膜脂肪体积差异最大(P<0.001)。Logistic 回归分析表明心外膜脂肪体积是影响易损斑块的独立危险因素(OR=2.015,P=0.001)。ROC曲线分析表明心外膜脂肪体积诊断易损斑块的阈值为103.7 cm3,诊断的敏感性与特异性分别为93.0%和61.8%(P<0.001)。结论双源CT测量心外膜脂肪体积与冠状动脉粥样硬化斑块的斑块性质、血管重构、点状钙化具有良好的相关性,可作为影响易损斑块的独立危险因素,并早期判断冠心病患者的预后。
目的:探討冠心病患者心外膜脂肪體積對冠狀動脈斑塊穩定性的影響。方法納入同期行雙源CT冠狀動脈成像與經皮冠狀動脈造影的冠心病患者145例,測量患者的身高、體重、血壓、血生化指標,通過64排雙源CT測定心外膜脂肪體積與斑塊性質、重構指數、點狀鈣化,併進行心外膜脂肪體積與易損斑塊的相關分析。結果年齡、性彆、吸煙、糖尿病、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、甘油三酯(TG)在斑塊性質、血管重構、點狀鈣化中的差異均無統計學意義(P>0.05)。LDL-C在斑塊性質與點狀鈣化中也無統計學差異(P>0.05),正性重構組 LDL-C 水平高于非正性重構組(P=0.040)。非鈣化斑塊組、正性重構組、點狀鈣化組的高血壓患病率、BMI與心外膜脂肪體積均高于鈣化斑塊組、非正性重構組、無點狀鈣化組(P<0.05),其中心外膜脂肪體積差異最大(P<0.001)。Logistic 迴歸分析錶明心外膜脂肪體積是影響易損斑塊的獨立危險因素(OR=2.015,P=0.001)。ROC麯線分析錶明心外膜脂肪體積診斷易損斑塊的閾值為103.7 cm3,診斷的敏感性與特異性分彆為93.0%和61.8%(P<0.001)。結論雙源CT測量心外膜脂肪體積與冠狀動脈粥樣硬化斑塊的斑塊性質、血管重構、點狀鈣化具有良好的相關性,可作為影響易損斑塊的獨立危險因素,併早期判斷冠心病患者的預後。
목적:탐토관심병환자심외막지방체적대관상동맥반괴은정성적영향。방법납입동기행쌍원CT관상동맥성상여경피관상동맥조영적관심병환자145례,측량환자적신고、체중、혈압、혈생화지표,통과64배쌍원CT측정심외막지방체적여반괴성질、중구지수、점상개화,병진행심외막지방체적여역손반괴적상관분석。결과년령、성별、흡연、당뇨병、총담고순(TC)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)、감유삼지(TG)재반괴성질、혈관중구、점상개화중적차이균무통계학의의(P>0.05)。LDL-C재반괴성질여점상개화중야무통계학차이(P>0.05),정성중구조 LDL-C 수평고우비정성중구조(P=0.040)。비개화반괴조、정성중구조、점상개화조적고혈압환병솔、BMI여심외막지방체적균고우개화반괴조、비정성중구조、무점상개화조(P<0.05),기중심외막지방체적차이최대(P<0.001)。Logistic 회귀분석표명심외막지방체적시영향역손반괴적독립위험인소(OR=2.015,P=0.001)。ROC곡선분석표명심외막지방체적진단역손반괴적역치위103.7 cm3,진단적민감성여특이성분별위93.0%화61.8%(P<0.001)。결론쌍원CT측량심외막지방체적여관상동맥죽양경화반괴적반괴성질、혈관중구、점상개화구유량호적상관성,가작위영향역손반괴적독립위험인소,병조기판단관심병환자적예후。
Objective To investigate whether epicardial adipose tissue (EAT) volume is related to coronary plaques stability in patients with coronary artery disease (CAD). Methods A total of 145 coronary heart disease patients who underwent dual-source 64-slice CT and percutaneous coronary angiography were included for this study. Each patients was taken the measurements of height, weight, BP and blood biochemical parameters. We evaluated all patients referred for 64-slice CT, and assessed EAT volume and vulnerable coronary plaque components-non-calcified plaques (NCPs), remodeling index (RI) and spotty calcium. The relationship was reviewed between EAT volume and vulnerable coronary plaques. Results There was no statistical difference in age, gender, smoking, DM, TC, HDL-C and TG(P>0.05). Hypertension, BMI and EAT volume were higher in NCPs, positive remodeling (PR) and spotty calcium, and there was statistical difference among them (P<0.05). The results of Logistic regression analysis showed that EAT volume was an independent predictor of vulnerable coronary plaques (OR=2.015, P=0.001). The curve of receiver operating characteristic (ROC) indicated that the diagnostic sensitive and specificity of vulnerable coronary plaques were respectively 93.0%and 61.8%when taking EAT volume 103.7 cm3 as threshold value (P<0.001). Conclusion EAT volume was associated with the presence of vulnerable plaque components, which was an independent predictor of vulnerable coronary plaques and forecast of CAD patients.