无粥样硬化人群冠周脂肪CT密度特征及与心血管危险因素的关系

CT characteristics of PCAT density and its relationship with cardiovascular risk factors in non-atherosclerotic population

目的:探讨无冠状动脉粥样硬化人群冠周脂肪组织(PCAT)CT密度特征及与心血管危险因素之间的关系。方法:入选经冠状动脉CTA检查证实无冠状动脉粥样硬化者143例,测量各支冠状动脉主支及不同节段的PCAT密度,以单因素方差分析(ANOVA)比较不同冠脉分支、不同节段间PCAT密度的差异,并以多变量Logistic回归分析筛选影响PCAT密度的心血管危险因素。结果:各节段平均PCAT密度为(-93.9±1.8)HU。在冠脉主支分析中,3支主要冠状动脉平均PCAT密度不同(P<0.001),LAD、LCX和RCA的PCAT密度分别为(-90.3±3.2)HU,(-88.5±4.7)HU,(-98.1±2.0)HU。在LAD及RCA中,PCAT密度由近到远呈减低趋势(P<0.001)。在冠脉节段分析中,LAD近段和LCX近段(P=0.692)、LAD中段和RCA中段(P=0.996)PCAT密度无显著差异,余各节段两两比较差异均具有统计学意义(P<0.05)。有吸烟史及CAD家族史者平均PCAT密度减低。结论:在无冠状动脉粥样硬化人群中,不同冠脉节段和血管间PCAT的CT密度存在一定差异,吸烟史和CAD家族史是PCAT密度的独立影响因素。

Objective:To analyze the CT characteristics of PCAT density and its relationship with cardiovascular risk factors in people without coronary atherosclerosis.Methods:The PCAT densities of main branches and different segments of each coronary artery were measured in 143 patients without coronary atherosclerosis confirmed by examination of CCTA.The differ-ence of PCAT density in different coronary artery vessels and segments was compared by one-way ANOVA and multivariate logistic regression analysis was used to analyse the cardiovascular risk factors affecting PCAT density.Results:The average PCAT density of each segment was(-93.9±1.8)HU.In the analysis of main coronary arteries,the PCAT density of LAD,LCX,RCA was(-90.3±3.2)HU,(-88.5±4.7)HU,(-98.1±2.0)HU,respectively,and the average PCAT densities of the three main coronary arteries were different(P<0.001).In LAD and RCA,the density of PCAT decreased from proximal to distal segments(P<0.001).In the analysis of coronary segments,there was no significant difference in PCAT density between proximal LAD and proximal LCX(P=0.692),middle LAD and middle RCA(P=0.996),but significant difference in the other segments(P<0.05).The decreasing PCAT density was associated with smoking history and CAD family history.Conclusion:In people without coronary atherosclerosis,results of CCTA showed difference in PCAT density among different coronary segments and ves-sels.Smoking history and a family history of CAD are independent influencing factors of PCAT density.