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目的评价心周脂肪组织(PAT)体积与传统心血管疾病危险因素的相关性及对冠心病的诊断预测价值。方法将南京军区南京总医院2006-12-01—2010-01-31同期行64排双源CT和经皮冠状动脉造影检查临床怀疑冠心病的患者310例,进行腰围、体重指数(BMI)、空腹血生化测定。使用64排双源CT测定PAT体积,通过经皮冠状动脉造影检查明确冠心病诊断。结果 (1)冠心病患者PAT体积明显大于非冠心病患者(P<0.01);(2)男性PAT体积明显大于女性(P<0.01);(3)PAT体积与年龄、性别、BMI、腰围、原发性高血压、糖尿病、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸、纤维蛋白原有相关性(P<0.05或P<0.01);(4)Logistic逐步回归分析显示,PAT体积、BMI、腰围是影响冠心病发生的独立危险因素;(5)PAT体积诊断冠心病的ROC曲线下面积为0.65±0.04(P<0.01),明显优于腰围和BMI。结论 PAT体积与已知传统的心血管疾病危险因素和冠心病的发生有强的相关性,并且反映了多个传统危险因素的聚类效应。PAT体积对冠心病诊断的预测价值优于腰围和BMI,可作为一个新的冠心病预测指标。
Objective To evaluate the correlation between the volume of peri-cardiac adipose tissue (PAT) and the risk factors of traditional cardiovascular diseases and the diagnostic value of coronary heart disease. Methods Three hundred and sixty-four patients with suspected coronary heart disease underwent 64-detector double-source CT and percutaneous coronary angiography at Nanjing General Hospital of Nanjing Military Region from December 2006 to January 2010. The waist circumference, body mass index (BMI) Fasting blood biochemical assay. PAT volume was measured with 64-row dual-source CT and a diagnosis of coronary heart disease was confirmed by percutaneous coronary angiography. Results: (1) PAT volume in patients with coronary heart disease was significantly higher than that in patients without coronary heart disease (P <0.01); (2) PAT volume in male patients was significantly greater than that in women (P <0.01); (3) (P <0.05 or P <0.01); (4) The correlation between hypertension, diabetes, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, uric acid and fibrinogen; Logistic stepwise regression analysis showed that PAT volume, BMI and waist circumference were independent risk factors for coronary heart disease. (5) The area under the ROC curve of PAT volume in diagnosis of coronary heart disease was 0.65 ± 0.04 (P <0.01), which was significantly better than waist circumference And BMI. Conclusions There is a strong correlation between PAT volume and known traditional cardiovascular risk factors and the occurrence of coronary heart disease and reflects the clustering effect of several traditional risk factors. The predictive value of PAT volume in the diagnosis of coronary heart disease is superior to waist circumference and BMI, which can be used as a new predictor of coronary heart disease.