心外膜脂肪厚度与冠状动脉狭窄及其相关危险因素的关系

Relationship between epicardium adipose thickness and severity of coronary artery stenosis and its associated risk factors

目的探讨冠心病患者心外膜脂肪厚度(EAT)与冠状动脉狭窄程度的关系。方法以经过冠状动脉造影确诊为冠心病的119例患者为研究对象,记录其身高、体重、腰围、血压等,检测受试者的血脂、空腹血糖、尿酸、肾功能、高敏C反应蛋白(hs-CRP)、空腹胰岛素水平(FINS)等指标,对冠状动脉狭窄程度进行定量Gensini积分,同时应用超声测量EAT,根据EAT值将患者分为低值、中值、高值3组。结果与EAT低值组比较,中、高值组患者腰围较大,hs-CRP、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)明显增高,高密度脂蛋白胆固醇(HDL-C)水平显著降低,组间比较差异有统计学意义(P<0.05)。EAT与年龄、腰围、体质量指数、hs-CRP、ISI、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)呈正相关(r=0.124～0.302,P<0.05或P<0.01),与HDL-C呈负相关(r=-0.251,P<0.01)。随着EAT值增加,Gensini积分明显增大。结论冠心病患者EAT与冠状动脉狭窄严重程度呈明显正相关。

Objective To investigate the relationship between epicardium adipose thickness （EAT） and the severity of coronary artery stenosis （CAS） in patients with coronary artery disease （CAD）. Methods Consecutive 119 patients who underwent coronary angiography and diagnosed with CAD were enrolled the study. The physiological indexes were recorded, included height, weight, waist circumference （WC） , blood pressure etc. The blood lipids, fasting plasma glucose （FPG）, uric acid, renal function, high-sensitivity C-reactive protein （hs-CRP）, fasting serum insu- lin（FINS） ,insulin resistance index （IRI） , were detected and followed up. The severity of CAS was quantified with Gensini scoring system. All cases were divided into 3 groups according to the EAT, which were evaluated with B-mode ultrasonography. Results Compared with the low value of EAT group, the WC, hs-CRP, FINS and IRI were higher in middle and high value of EAT group, while the level of high-density lipoprotein cholesterol （ HDL-C ） was lower （ P 〈 0.05）. It showed that there were positive correlations between EAT and the age, WC, BMI, hs-CRP, IRI, TG, LDL-C （r = 0. 124 - 0. 302, P 〈 0.05 or P 〈 0.01 ）, the negative correlation between EAT and HDL-C （ r = -0.251, P 〈 0.01 ）. The patients had higher value of EAT, associated with Gensini＇ s score. Conclusion It suggested that the EAT had positive correlation with the severity of CAS in patients with CAD.