侯小玲,付振虹,单冬凯,张威,陈韵岱

• 1:解放军总医院第一医学中心心内科

摘要(Abstract)：

目的探讨心外膜脂肪组织(EAT)与冠心病患者经皮冠状动脉介入治疗(PCI)相关短期并发症的关系。方法回顾性分析解放军总医院第一医学中心心内科自2014年1月至12月209例术前已行冠状动脉CT血管造影的冠心病患者的PCI手术相关临床资料,测定EAT体积并分析术中及术后30 d内发生的短期并发症,对可能影响并发症的因素进行分析。结果 209例患者PCI术前的EAT体积为(129.3±49.7)ml,有18例(8.6%)患者发生短期并发症,包括:10例(4.8%)冠状动脉夹层,其中1例合并术中冠状动脉穿孔,1例合并术后出血;6例(2.9%)出血;2例(1.0%)心肌梗死,其中1例合并心原性休克;1例脑梗死。单因素分析发现,高血压病、EAT体积大(>130 ml)、多支病变、置入支架数量多的患者,PCI术中及术后短期并发症发生率显著增高(均P<0.05)。logistic多因素分析显示,EAT体积大(>130 ml)(OR 4.268,95%CI 1.422～12.812,P=0.010)和多支病变(OR 5.113,95%CI 1.786～14.638,P=0.002)是PCI术后并发症的独立危险因素。结论 EAT体积大(>130 ml)是PCI相关短期并发症的独立危险因素。术前测定EAT可能对PCI术中及术后短期并发症的预测具有一定的价值。

关键词(KeyWords)： 心外膜脂肪;经皮冠状动脉介入治疗;并发症;预测因素

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目课题(2016YFC1300304);; 领航基金课题项目(LHJJ201611827)

作者(Author): 侯小玲,付振虹,单冬凯,张威,陈韵岱

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