心外膜脂肪组织及颈动脉内中膜厚度对冠心病的预测价值

Predictive value for coronary heart disease by epicardial adipose tissue and carotid intima-media thickness

目的 探讨高频超声测量心外膜脂肪组织及颈动脉内中膜厚度对冠心病的预测价值.方法 应用高频超声分别测量正常对照组（29例）、冠心病单支病变组（43例）、冠心病多支病变组（28例）的心外膜脂肪组织及颈动脉内中膜厚度,并进行比较.结果 正常对照组、冠心病单支病变组、冠心病多支病变组心外膜脂肪组织厚度分别为（4.8±1.3）mm、（7.6±1.8）mm、（10.1±2.6）mm,颈动脉内中膜厚度分别为（0.8±0.1）mm、（1.0±0.2）mm、（1.1±0.2）mm;三组间心外膜脂肪组织及颈动脉内中膜厚度差异有统计学意义（P＜0.01）.心外膜脂肪组织厚度预测冠心病存在的ROC曲线下面积为0.947,以心外膜脂肪厚度＞6 mm为截断值预测冠心病的敏感性为90.1%,特异性为86.2%.颈动脉内中膜厚度预测冠心病存在的ROC曲线下面积为0.917,以颈动脉内中膜厚度0.85 mm为截断值预测冠心病的敏感性为87.3%,特异性为82.8%.二者曲线下面积比较,差异无统计学意义（P＞0.05）.结论 心外膜脂肪组织及颈动脉内中膜厚度能准确预测冠心病,心外膜脂肪组织厚度可以作为冠心病的一个新的预测因子.

Objective To explore the predictive value for coronary heart disease by epicardial adipose tissue（EAT） thickness and carotid intima-media thickness（IMT） measured with high-frequency ultrasound.Methods According to the results of coronary angiography, the cases were divided into the normal control group （29 patients）,coronary artery disease group with single-vessel lesion （43 patients）,coronary artery disease group with multi-vessels lesion （28 patients）, respectively. EAT and IMT were measured by high-frequency ultrasound. Results The EAT in the three groups were （4.8 ± 1.3） mm, （7.6 ± 1.8） mm,（10.1±2.6） mm respectively, and the IMT were （0.8±0.1）mm,（1.0±0.2）mm,（1.1 ± 0.2）mmrespectively. In either coronary artery disease group with single-vessel lesion or multi-vessels lesion, the EAT and IMT were significantly higher than those in the normal control group （ P〈 0.01 ）. And the difference between groups of single-vessel lesion and multi-vessels lesion was also statistically significant （P〈 0.01）. The areas under receive operating characteristic（ROC） curve to predict coronary heart disease by EAT and IMT was 0.947 and 0.917, respectively, there was no significant difference between the two areas. For patient with coronary artery stenosis〉50%, the sensitivity and specificity of EAT〉6 mm were 90.1% and 86.2% ,respectively,the sensitivity and specificity of IMT〉0.85 mm were 87.3% and 82.8%,respectively. Conclusions EAT and IMT measured by high-frequency ultrasound can precisely predictcoronary heart disease. EAT can be a new predictor to diagnose coronary heart disease.