心包脂肪组织体积与冠状动脉CT血管造影管腔狭窄程度的相关性研究

摘要

Objective:The aim of the study was to assess the association between pericardial adipose tissue(PAT) volume with extentof lumens stenosis as detected by coronary computed tomography angiography(CCTA). Methods: This study consisted of 1597 consecutive patients who underwent 320-raw CCTA examination for the evaluation of doubtful coronary artery disease.(males 1090 cases, females 507 cases;age 18-55 years), Of which 382 cases are found arterial plaques.We compared PAT volume in patients with 1-vessel, 2-vessels, 3-vessels and 4-vessels lesion and non-stenosis, respectively. We compared simultaneously PAT volume in patients with coronary atherosclerotic plaques (presence plaque, calcified plaque[CP], non-calcified plaque [NCP], and mixed plaque[MP]) and without coronary atherosclerotic plaques. Results: Pearson correlation and regression analysis showed that PAT volume was positively correlated with numbers of vessel lesionand.Univariate analysis showed the PAT volume in patients with presence of CP, NCP, MP and multi vessel disease larger than those without plaques respectively (211.4±93.6) cm3, (233.2±95) cm3, (257.3±82.1) cm3 and (261.5±101.7) cm3 vs (173.7±98.1) cm3, t=4.89, t=7.11, t=9.66, t=11.65; P<0.05). In multivariate Cox proportional hazards regression analysis, only the PAT volume in patients with MP, multivessel disease and obstructive stenosis was significantly higher than those without plaques (OR=4.79, 2.03-13.16, 95%CI, P<0.001). Conclusion:The PAT volume in patients with presence of coronary plaques, CP, NCP, MP, multivessel disease and obstructive stenosis greater than those without plaque, PAT volume is an important risk factor for coronary heart disease.%目的：评估心包脂肪组织(PAT)体积与320排冠状动脉CT造影(CCTA)动脉管腔狭窄程度的关系。方法：选取因可疑冠心病而接受320排CCTA检查的患者1597例，其中发现存在动脉斑块的患者382例，分别比较1支、2支、3支以及4支冠状动脉病变和无狭窄或管腔不规则狭窄、轻度狭窄、中度狭窄、重度狭窄以及闭塞者的PAT体积。同时比较了存在斑块、钙化斑块(CP)、非钙化斑块(NCP)和混合斑块(MP)与无冠心病者的PAT体积。结果：Pearson相关回归分析显示， PAT体积分别与冠状动脉病变支数和冠状动脉管腔狭窄程度呈正相关。单因素分析显示存在CP、NCP、MP及多支病变者的PAT体积大于无斑块者分别为(211.4±93.6) cm3、(233.2±95) cm3、(257.3±82.1) cm3及(261.5±101.7) cm3，与无斑块者(173.7±98.1) cm3比较差异有统计学意义(t=4.89，t=7.11，t=9.66，t=11.65；P＜0.05)。在多因素Cox比例风险回归模型分析中，只有PAT体积明显增大是存在MP者的独立预测因子(危害比=4.79(2.03-13.16)(95%CI)，P＜0.001)。结论：PAT体积与冠状动脉病变支数和狭窄程度呈正相关。PAT体积明显增大是存在MP者的独立预测因子，PAT体积是冠心病重要的危险因素之一。