双源CT心周脂肪定量与冠状动脉粥样硬化病变程度的相关性

Association of Pericardial Adipose Tissue Measured by Dual Source Computed Tomography with Severity of Coronary Atherosclerosis

目的分析心周脂肪体积与心血管危险因素、冠心病的发生和冠状动脉狭窄程度之间的关系。方法221例同期行64排双源CT和经皮冠状动脉造影检查的患者入选,进行腰围、体质指数和空腹血生物化学指标测定。使用64排双源CT测定心周脂肪体积,通过经皮冠状动脉造影检查明确患者的冠心病诊断和冠状动脉病变支数,并采用Gensini积分量化冠状动脉狭窄的严重程度。结果入选患者男性占71.04%。男性心周脂肪体积明显大于女性(241.44±78.08cm3比216.46±64.36cm3,P=0.025)。年龄≥70岁的患者心周脂肪体积明显大于年龄<70岁的同性别患者(P<0.05)。冠心病患者的心周脂肪体积明显大于非冠心病患者(242.10±75.80cm3比189.23±52.26cm3,P<0.001)。Logistic回归分析显示心周脂肪体积(OR=1.11,P<0.001)和体质指数(OR=1.01,P=0.001)是影响冠心病发生的独立危险因子。心周脂肪体积随着冠状动脉病变支数的增加而增加,并且与Gensini积分呈正相关。结论64排双源CT可对心周脂肪组织进行准确定量,心周脂肪体积与心血管危险因素和冠心病的发生以及冠状动脉病变程度存在较强的相关性,可作为一个新的评估冠心病风险和病变程度的指标。

Aim To investigate the relation of pericardial adipose tissue（PAT） volumes to risk factors,presence of coronary artery disease,and severity of coronary atherosclerosis.Methods 221 consecutive patients who underwent dual-source 64-slice CT and diagnostic coronary angiography were studied.Each subject was measured in waist circumference,body mass index（BMI）,blood biochemical index and was estimated in cardiac parameters.PAT volume was determined by dual source CT.Coronary angiograms were analyzed for the diagnosis of coronary artery disease（CAD）.Gensini score was used for assessment of severity of coronary atherosclerosis.Results PAT volume was significantly higher in men than that in women（241.44 ± 78.08 cm^3 vs 216.46 ± 64.36 cm^3,P=0.025）.PAT volume in patients with CAD was significantly higher than that in patients without CAD（242.10±75.80 cm^3 vs 189.23±52.26 cm^3,P〈0.001）.Logistic regression analysis revealed that PAT volume （OR=1.11） and BMI （OR=1.01） were independent factors affecting the presence of CAD （P=0.001）.PAT volume was significantly associated with the number of coronary arteries with ≥50% stenosis and Gensini score.Conclusion Elevated PAT volumes was significantly correlated with traditional risk factors for the development of cardiovascular disease,presence of coronary artery disease,and severity of coronary atherosclerosis.PAT volume may be a new index of assessing CAD risk and predicting the extent and activity of CAD.