老年人心周脂肪组织含量与代谢危险因素及冠心病的相关性

Correlation of pericardial adipose tissue with coronary artery disease in patients over sixty

目的:探讨老年人心周脂肪组织(PAT)含量与代谢危险因素及冠心病之间的关系。方法:选取因胸痛住院并例行CT检查的老年患者(年龄>60岁)及有完整健康档案的体检者共483例,其中223人行冠状动脉CT血管造影,测定PAT含量、冠状动脉钙化积分;根据冠状动脉直径狭窄≥50%或达到临床诊断标准将研究对象分为冠心病组273例和非冠心病组210例,比较代谢危险因素数量和PAT含量在两组间的差异以及两者与冠心病的相关性。结果:非冠心病组和冠心病组比较,PAT含量差异无统计学意义[(190.9±69.24)cm3vs(185.72±53.01)cm3,P>0.05];随代谢危险因素数量的增加,PAT含量虽有上升趋势,但差异无统计学意义(P>0.05)。结论:对于老年患者,单纯PAT含量测量不能预测冠心病风险,而应综合患者年龄、合并代谢危险因素的数量及治疗用药来进行评估。

Objective： To explore the relationship between volume of PAT and coronary artery atherosclerosis and metabolic risk factors in patients over sixty. Methods： 483 patients over sixty years who had pectoralgia and underwent 64 slice CT were studied. They were in-patient or had health check-up files. 223 patients underwent cardiac multislice computed tomography to measure PAT volume and coronary artery calcium score. Theses patients were divided into coronary artery disease（ CAD） and non-CAD group based on the presence of ≥50% stenosis or reaching clinical diagnosis standard. The patients were grouped according to the number of metabolic risk factors,then PAT volume was compared among the groups. Results： PAT volume was not significantly higher in patients with CAD than that in non-CAD subjects [（ 190. 9 ± 69. 24） cm3vs（ 185. 72 ± 53. 01） cm3,P〉0. 05]. As the number of metabolic risk factors increased,the volume of PAT increased correspondingly,but not significant among the groups（ P〉0. 05）. Conclusion： For patients older than sixty,MDCT measurement of pericardial adipose tissue volume alone can not predict the risk of coronary artery disease,while patients＇ age combined with risky factors and drugs applied should be comprehensively considered.