心外膜脂肪密度与冠状动脉斑块的相关研究

A study on the relationship between epicardial adipose tissue density and coronary artery plaque

目的：探讨CT测量心外膜脂肪组织的密度与冠状动脉粥样硬化斑块的关系。方法：417例疑似冠心病患者行多螺旋CT造影检查,精确测量相应心外膜脂肪密度。根据造影检查结果分为斑块组及非斑块组,并进一步将斑块组分为3个亚组,即钙化斑块组、混合斑块组、非钙化斑块组,并按照不同性别和年龄分组,比较斑块侧与非斑块侧心外膜脂肪密度。结果：1417例患者纳入研究,其中斑块组189例,其中钙化斑块者42例,非钙化斑块59例,混合斑块83例;无斑块者228例。2斑块侧心外膜脂肪密度（以CT值比较）高于非斑块侧,两者之间存在统计学差异（40.84±37.28 vs.23.81±30.81,P=0.000）,无论男性还是女性,斑块侧心外膜脂肪密度均高于非斑块侧（男,t=8.78,P=0.000;女,t=5.941,P=0.000）;按年龄分层后,心外膜脂肪密度在45岁组以下（t=7.012,P=0.000）、45~〈55岁组（t=3.459,P=0.002）、55~〈65岁组（t=5.416,P=0.000）、65岁以上组（t=7.750,P=0.000）均为斑块组大于非斑块组,均存在统计学意义;斑块侧与非斑块侧心外膜脂肪密度均以非钙化斑块组的值最高,钙化斑块组最低,差异有统计学意义。相同性质各斑块组内斑块侧心外膜脂肪密度均大于非斑块侧,差异有统计学意义。结论：心外膜脂肪密度与冠状动脉粥样硬化斑块形成存在密切关系,与斑块性质有关。

Objective： To explore the relationship between epicardial adipose tissue （EAT） and coronary artery plaque. Methods： 417 patients suspected with coronary artery disease underwent coronary artery CT angiography. EAT density of each subject was semiautomatically calculated. The patients were divided into plaque and no plaque group based on coronary artery CT angiography, and the plaque group were subdivided into calcified, mixed and non-calcified plaque group. EAT density in each group was compared according to gender and age. Results： 417 patients were enrolled in this study. Among 184 patients with coronary artery plaque, 42 were calcified, 59 were non-calcified, 83 were mixed and 228 had no plaque. EAT density was significantly increased in the coronary artery plaque patients. Significant difference in EATV was observed between the plaque and no plaque groups（40.84±37.28 vs. 23.81±30.81, P=0.000） with no relationship to gender（male, t=8.78, P=0.000, fe- male, t=5.941, P=0.000）. There was significant difference between the plaque and non-plaque groups in EAT density by dif- ferent age groups（〈45 years t=7.012, P=0.000, 45-〈55 years t=3.459, P=0.002, 55-〈65 years t=5.416, P=0.000, ≥65 years t= 7.750, P=0.000）. There was significant difference between different plaque characteristics in EAT density （calcified plaque groups t=4.426, P=-0.000, non-calcified plaque groups t=6.784, P=0.000, mixed plaque groups t=6.710, P=0.000）. Conclusions： EAT density was correlated with coronary artery plaque with a close relationship to plaque characteristic.