心外膜脂肪含量与高血压患者冠状动脉钙化的相关性研究

Association between Epicardial Adipose Tissue Volume and Coronary Artery Calcification in Patients with Hypertension

目的探讨高血压患者心外膜脂肪组织体积(EATV)与冠状动脉钙化(CAC)的相关性。方法纳入2014年11月~2017年7月于承德医学院附属医院行冠状动脉CT血管造影(CCTA)检查的高血压患者408例,计算患者的冠状动脉钙化积分(CACS),依据CACS将患者分为研究组(CACS>0,n=283)和对照组(CACS=0,n=125),收集患者的临床资料,并计算患者的EATV。受试者工作特征(ROC)曲线确定EATV对高血压合并CAC的最佳诊断界值;Logistic回归分析高血压合并CAC的危险因素;分析高血压患者EATV与CACS的相关性。结果研究组EATV高于对照组(P<0.05);EATV诊断高血压合并CAC的ROC曲线下面积(AUC)为0.647,当最佳诊断界值为166cm^(3)时,诊断敏感度、特异性分别为43.7%、87.0%(P<0.05);Logistic回归分析显示,EATV≥166cm^(3)、TC≥5.20mmol/L、糖尿病、男性为高血压合并CAC的危险因素(P<0.05);EATV与高血压患者CACS呈正相关(r=0.235,P<0.05)。结论在高血压患者中,EATV与CACS呈正相关,对诊断高血压合并CAC具有提示意义,高EATV是高血压合并CAC的独立危险因素。

Objective To study the correlation between epicardial adipose tissue volume(EATV)and coronary artery calcification(CAC)in patients with hypertension.Methods A total of 408 patients with hypertension who underwent coronary computed tomographic angiography from November 2014 to July 2017 were selected from Affiliated Hospital of Chengde Medical College,and the coronary artery calcification score(CACS)of the patients was calculated.According to CACS,the patients were divided into the experimental group(CACS>0,n=283)and the control group(CACS=0,n=125).Clinical data of patients were collected,and the EATV of patients was calculated.Receiver operating characteristic curve(ROC)analysis and Logistic regression analysis was conducted to assess the optimal cutoff and value of the EATV for predicting CAC in hypertension.The correlation between the EATV and CACS in patients with hypertension was analyzed.Results The EATV was higher in the experimental group than that in the control group(P<0.05).The area under the curve(AUC)of EATV for diagnosing hypertension combined CAC was 0.647.When the cut off value was 166cm^(3),the diagnostic sensitivity and specificity were 43.7%and 87.0%,respectively(P<0.05).Logistic regression analysis showed that EATV≥166cm^(3),TC≥5.20mmol/L,diabetes mellitus and male were the risk factors of hypertension complicated with CAC(P<0.05).There was a positive correlation between EATV and CACS in patients with hypertension(r=0.235,P<0.05).Conclusion In patients with hypertension,EATV was positively correlated with CACS,which has certain diagnostic significance for hypertension complicated with CAC.High EATV is an independent risk factor for hypertension complicated with CAC.