周世功,刘志忠,金国珍,刘玄德,单守杰

• 1:南京市第一医院心内科
• 2:凤阳县人民医院心内科

摘要(Abstract)：

目的 探讨心外膜脂肪组织体积（EATV）与稳定性冠心病（SCAD）患者粥样硬化斑块负荷和成分的关系。方法 纳入2016年5月至2018年10月在南京市第一医院心内科门诊行冠状动脉CT血管造影显示阳性，计划行经皮冠状动脉介入治疗的SCAD患者76例，回顾性分析其临床资料，并测定EATV。所有患者冠状动脉在支架置入前行彩色编码血管内超声（iMAP-IVUS）成像，分析斑块组织学特征。结果 76例患者平均EATV为（109.17±43.34）cm~3，根据EATV平均值将患者分为低EATV组（EATV<109.17 cm3,38例）和高EATV组（EATV≥109.17 cm~3,38例）。高EATV组总管腔体积、总血管体积、总斑块体积、纤维成分体积和脂质成分体积显著高于低EATV组，差异均有统计学意义（均P<0.05）。EATV与纤维成分体积百分比之间呈显著负相关（r=–0.75,P=0.012），与坏死成分体积百分比之间呈显著正相关（r=0.68,P=0.009）。EATV与右冠状动脉（r=0.51,P=0.043）和左前降支（r=0.54,P=0.029）易损斑块有关。低密度脂蛋白胆固醇水平（β=0.16,P=0.019）和EATV(β=0.14,P=0.013)为斑块中高坏死成分体积百分比的预测因子。结论 EATV增加与SCAD患者冠状动脉斑块负荷和成分有关，右冠状动脉和左前降支斑块更具易损性。

关键词(KeyWords)： 冠心病;心外膜脂肪组织;斑块;彩色编码血管内超声

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 周世功,刘志忠,金国珍,刘玄德,单守杰

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