超声测量心外膜脂肪厚度与中青年缺血性脑卒中的相关性研究

Correlation between epicardial fat thickness measured by echocardiography and ischemic stroke in young and middle-aged people

目的:探讨超声测量的心外膜脂肪厚度(EFT)与中青年缺血性脑卒中发病的相关性。方法:选取46例首次就诊的中青年缺血性脑卒中患者作为病例组;同期就诊年龄与性别匹配的50例中青年非缺血性脑卒中人群作为对照组。入组后超声测量颈动脉内-中膜厚度(IMT)及EFT等指标。分析两组EFT和IMT的差异;收缩末期EFT在左室长轴与左室短轴切面的相关性;分析IMT、EFT与缺血性脑卒中的相关性;绘制EFT预测中青年缺血性脑卒中发生的受试者工作特征(ROC)曲线。结果:病例组EFT高于对照组(P<0.05);两组IMT无统计学差异(P>0.05);收缩末期胸骨旁左室长轴切面与短轴切面测量的EFT正相关(r=0.983,P<0.05);EFT增厚为预测中青年缺血性脑卒中的危险因素;ROC曲线表明,收缩末期左室长轴切面EFT和左室短轴切面EFT预测缺血性脑卒中发生的曲线下面积分别为0.865、0.856,最佳阈值分别为3.81 mm、4.18 mm。结论:超声测量EFT增加与中青年缺血性脑卒中发生相关,是中青年缺血性脑卒中发生的危险因素之一,对中青年缺血性脑卒中高危对象有一定筛查价值。

Objective:To investigate the correlation between epicardial fat thickness(EFT)measured by echocardiography and ischemic stroke in young and middle-aged people.Methods:46 young and middle-aged patients with ischemic stroke were selected as case group,50 Young and middle-aged non-ischemic stroke patients(mean age)were selected as the control group.The intima-media thickness(IMT)and EFT of carotid artery were measured.The difference of EFT and IMT between the two groups was analyzed,and the correlation between systolic EFT and left ventricular long-axis and short-axis was analyzed,the correlation between IMT,EFT and ischemic stroke was analyzed,and the ROC curve of EFT was drawn to predict the occurrence of ischemic stroke in young and middle-aged people.Results:EFT was higher in the case group than that in the control group(P<0.05),there was no statistically significant difference in IMT between the two groups(P>0.05).There were positive correlation between EFT measured on parasternal left ventricular long-axis and short-axis sections in the end-systolic period(r=0.983,P<0.05).EFT thickening was a risk factor for ischemic stroke in young and middle-aged people.ROC curve showed that the areas under the curve of EFT on long axis and short axis of left ventricle in the end-systolic period were 0.865 and 0.856 respectively,and the optimal thresholds were 3.81 mm and 4.18 mm respectively.Conclusion:The increase in EFT measured by ultrasound is associated with the occurrence of ischemic stroke in young and middle-aged people,and is one of the risk factors for ischemic stroke in young and middle-aged people.It has certain screening value for high-risk subjects of ischemic stroke in young and middle-aged people.