冠状动脉CTA周围脂肪组织平均衰减与斑块及狭窄相关性分析

Correlation analysis of average attenuation of adipose tissue around coronary artery CTA with plaque and stenosis

目的 探究冠状动脉CTA周围脂肪组织平均衰减(PCATMA)与冠状动脉斑块的存在、类型和严重程度的关系。方法 选取我院收治的冠心病患者100例,冠状动脉CTA周围脂肪组织平均衰减检测患者冠状动脉、左前降支(LAD)、左回旋支(LCX)和右冠状动脉(RCA),排除图像清晰度不够者,合计纳入295个检测点。观察不同CAC评分和狭窄程度患者PCATMA表达,不同斑块类型和狭窄程度的近端和病灶PCATMA表达及PCATMA表达与斑块、狭窄相关性。结果 随着患者CAC评分及狭窄程度升高,PCATMA表达升高,差异具有统计学意义(P<0.05);不同斑块类型和狭窄程度的近端和病灶PCATMA表达差异具有统计学意义(P<0.05),病灶处PCATMA表达略高于近端,但两者相比无显著差异(P>0.05);Logistic多因素回归分析显示,斑块存在、斑块类型、斑块类型负担及狭窄程度均是影响PCATMA表达的独立因素(P<0.05)。结论 PCATMA表达与CAD患者病情发生发展具有密切联系,随着患者斑块钙化、动脉狭窄程度增加,其表达呈现上升趋势,可能作为患者预后的关键指标之一。

Objective To explore the relationship between the mean attenuation of adipose tissue around coronary CTA(PCATMA) and the presence, type and severity of coronary plaque. Methods We selected 100 patients with coronary heart disease who were admitted to our hospital in this study. The average attenuation of adipose tissue around the coronary artery CTA was detected in the patients’ coronary artery, left anterior descending artery(LAD), left circumflex artery(LCX) and right coronary artery(RCA). We excluded those with insufficient image clarity, included a total of 295 inspection points, and observed the expression of PCATMA in patients with different CAC scores and degrees of stenosis, the expression of PCATMA in proximal and lesions of different plaque types and degrees of stenosis, and the correlation between PCATMA expression and plaque and stenosis. Results As the CAC score and degree of stenosis increased, the expression of PCATMA increased, and the difference was statistically significant(P<0.05);the difference in PCATMA expression in proximal and lesions with different plaque types and degrees of stenosis was statistically significant(P<0.05), the expression of PCATMA at the lesion was slightly higher than that at the proximal end, but there was no significant difference between the two(P>0.05);Logistic multivariate regression analysis showed that the presence of plaque, plaque type, burden of plaque type, and degree of stenosis were all independent factors affecting the expression of PCATMA(P<0.05). Conclusion The expression of PCATMA is closely related to the occurrence and development of CAD patients. With the increase of plaque calcification and arterial stenosis in patients, its expression shows an upward trend, which may be used as one of the key indicators of patient prognosis.