超声测量心外膜脂肪组织厚度对冠心病的诊断预测价值

Diagnostic and predictive value of visceral adipose thickness in severity of coronary stenosis

目的评价经超声测量的心外膜脂肪组织厚度(visceral adipose thickness,EAT)对冠状动脉狭窄程度的预测价值。方法共有147例接受冠状动脉造影患者入选本研究,根据造影结果,分为冠状动脉粥样硬化性心脏病(冠心病)(coronary artery disease,CAD)组101例和非CAD组46例。对所有患者采集病史,体检并进行实验室检查,超声测量EAT。对各组之间的EAT值进行比较,将患者的冠状动脉病变积分(coronary artery core,CAS)值与EAT进行相关性分析。结果 CAD组的EAT显著高于非CAD组,差异有统计学意义[(7.41±1.63)mm vs.(4.41±1.60)mm,P<0.01]。严重冠状动脉病变组EAT较轻度冠状动脉病变组EAT明显升高[(8.53±1.00)mm vs.(7.16±1.73)mm,P<0.01]。相关分析显示,CAS与EAT呈正相关(r=0.71,P<0.001)。以EAT值≥5.35mm诊断CAD,诊断敏感性87.13%,特异性80.43%,ROC曲线下面积为89%(95%可信区间0.84～0.95;P=0.01)。结论由超声测量的EAT可作为评价冠状动脉病变程度简便、可靠和实用的评价指标,和CAD关系密切,可作为CAD患者无创的协同诊断方法之一,用于对CAD患者的筛查。

Objectives To evaluate the diagnostic predictive value of visceral adipose thickness （EAT） in the severity of coronary stenosis. Methods We divided 147 patients into two groups： coronary artery disease （CAD） group（n=101 ） and control group （rt=46）by diagnostic coronary angiography.All patients underwent echocardiographic measurement of EAT and blood biochemical index. In addition, their history were collected. EAT of the groups were compared. Correlation analysis was taken on coronary artery core（CAS） and EAT. Results EAT was significantly higher in CAD group than that in control group [ （ 7.41 ± 1.63 ）mm vs. （4.41 ±1.60） mm, P〈0.01 ]. Furthermore, EAT in sever group of CAD was higher than that in slight group of CAD [ （ 8.53± 1.00） mm vs. （ 7.16±1.73 ） ram, P〈0.01 ]. CAS significantly correlated with EAT （r=0.71 ,P〈0.01）. EATs〉5.35 mm had 87.13% sensitivity and 80.42% specificity （ROC area 89%,P=0.01, 95% CI 0.84-0.95] for predicting CAD. Conclusions EAT is a simple and practical method for the assessment of the severity of coronary stenosis. It＇ s closely associated with CAD and can be one of noninvasive ways in the collaborative diagnosis for CAD.