经胸超声心动图测量心脏外膜脂肪厚度与老年冠心病患者的相关性研究

Relationship between epicardial adipose tissue thickness measured by transthoracic echocardiography and CHD in the elderly

目的评价经胸超声心动图（TTE）测量心脏外膜脂肪（EAT）厚度与老年冠心病患者的相关性和预测价值。方法将77例年龄≥60岁的患者根据冠状动脉造影诊断分为冠心病组57例和非冠心病组20例。TTE测量EAT厚度,比较2组临床资料及EAT厚度的差异,并利用logistic回归模型和ROC曲线分析EAT厚度与冠心病的关系及诊断价值。结果冠心病组EAT厚度明显高于非冠心病组[（5.26±1.77）mmvs（3.60±1.03）mm,P=0.000）]。冠心病组EAT厚度≥4.14mm比例明显高于非冠心病组（71.9%vs 25.0%,P=0.000）。logistic回归分析显示,EAT厚度增加（OR=6.009,95%CI：1.436～25.148,P=0.014）是冠心病的1项独立危险因素。EAT厚度≥4.14 mm诊断冠心病的敏感性为71.9%,特异性为75.0%,ROC曲线下面积为0.783（95%CI：0.678～0.889,P〈0.01）。结论老年人采用TTE测量的EAT厚度与冠心病发生密切相关,其可作为老年冠心病筛查的一种有效的无创检查方法。

Objective To evaluate the relationship between epicardial adipose tissue （EAT） thick- ness measured by transthoracic echocardiography （TTE） and CHD in the elderly. Methods Sev- enty-seven patients with their age ~60 years were divided into CHD group （n=57） and non-CHD group （n=20） according to their coronary arterioangiography. Their EAT thickness was measured by TTE. The clinical data and EAT thickness were compared between the two groups. The rela- tionship between EAT thickness and CHD was analyzed using logistic regression model and ROC curve. Results The EAT thickness was significantly thicker in CHD group than in non-CHD group （5.26±1.77 mm vs 3.60±1.03 ram,P=0. 000）. The ratio of EAT thickness ≥4.14 mm was significantly higher in CHD group than in non-CHD group（71. 90% vs 25.0%,P=0. 000）. Logistic regression analysis showed that the EAT thickness was an independent risk factor for CHD （OR=6. 009,95%CI：1. 436-25. 148,P=0. 014）. The sensitivity and specificity of EAT thickness ≥ 4.14 mm were 71. 9% and 75.0% for the diagnosis of CHD,the area under ROC curve was 0. 783 （95%CI：0. 678-0. 898,P〈0.01）. Conclusion The EAT thickness measured by TTE is closely related with CHD in the elderly with their age ≥60 years and can thus be used as an effective non-invasive method in diagnosis of CHD in the elderly.