王璟,宫剑滨,张龙江,朱飞鹏,王立军,彭永平,江时森

• 1:南京军区南京总医院心脏内科
• 2:南京军区南京总医院医学影像科

摘要(Abstract)：

目的本研究通过64排双源CT测定心周脂肪组织(PAT)体积,分析PAT体积与冠状动脉病变支数、病变部位、病变狭窄程度以及斑块类型之间的关系,以期探讨PAT体积对冠状动脉粥样硬化病变程度的预测价值。方法同期行64排双源CT和经皮冠状动脉造影检查的310例患者入选,进行腰围、体质指数(BMI)、空腹血生化测定。使用64排双源CT测定PAT体积、钙化积分和斑块类型。通过经皮冠状动脉造影检查明确冠心病诊断、病变支数、病变部位,并采用Gensini积分量化冠状动脉狭窄的严重程度。结果 (1)冠心病患者的PAT体积明显大于非冠心病患者(P=0.004);急性冠脉综合征患者的PAT体积明显大于稳定性心绞痛患者(P=0.009)。(2)双支和三支病变患者PAT体积与单支病变患者相比,PAT体积明显增加(P<0.001)。(3)Gensini积分随着PAT体积增大而增加。(4)多元线性逐步回归分析显示PAT体积、BMI、空腹血糖是影响Gensini积分的独立危险因素。(5)PAT体积与钙化积分具有明显正相关性(r=0.31,P<0.001)。(6)混合型斑块的PAT体积最大,其病变节段积分明显高于其他类型(P<0.01)。结论 PAT体积与冠心病的发生、冠心病分型、冠状动脉病变支数、钙化积分存在强的相关性,是影响Gensini积分的独立危险因素。

关键词(KeyWords)： 心脏;脂肪类;动脉粥样硬化;冠状血管造影术;双源CT

Abstract:

Keywords:

基金项目(Foundation): 南京军区医学科技创新重点课题(09Z026);; 南京军区南京总医院青年基金课题(2009Q003)

作者(Author): 王璟,宫剑滨,张龙江,朱飞鹏,王立军,彭永平,江时森

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