[1]王海宇 单裕清 王超 穆乃文 王耿 侯志辉.冠状动脉周围脂肪组织参数在评估冠状动脉狭窄程度中的价值[J].心血管病学进展,2025,(5):475.[doi:10.16806/j.cnki.issn.1004-3934.2025.05.020]
　WANG Haiyu,SHAN Yuqing,WANG Chao,et al.The Value of Pericoronary Adipose Tissue in Assessing the Severity of Coronary Artery Stenosis[J].Advances in Cardiovascular Diseases,2025,(5):475.[doi:10.16806/j.cnki.issn.1004-3934.2025.05.020]
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冠状动脉周围脂肪组织参数在评估冠状动脉狭窄程度中的价值()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年5期
页码:
475
栏目:
论著
出版日期:
2025-05-25

文章信息/Info

Title:
The Value of Pericoronary Adipose Tissue in Assessing the Severity of Coronary Artery Stenosis
作者:
王海宇1 单裕清1 王超1 穆乃文1 王耿1 侯志辉2
(1.日照市人民医院医学影像科,山东 日照 276800;2. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院放射影像科,北京 100037)
Author(s):
WANG Haiyu1; SHAN Yuqing1; WANG Chao1; MU Naiwen1; WANG Geng1; HOU Zhihui2
Department of Medical Imaging,Peoples Hospital of Rizhao,Rizhao 276800,Shandong,China; 2. Department of Radiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)
关键词:
冠状动脉CT血管成像; 冠状动脉周围脂肪组织; 脂肪衰减指数
Keywords:
Coronary artery computed tomography angiography; Pericoronary adipose tissue; Fat attenuation index
DOI:
10.16806/j.cnki.issn.1004-3934.2025.05.020
摘要:
目的 探讨冠状动脉周围脂肪组织（PCAT）参数在评估冠心病严重程度上的应用价值。方法 回顾性分析中国医学科学院阜外医院和日照市人民医院2022年3月—2024年8月行冠状动脉CT血管成像及冠状动脉造影的患者290例，根据冠状动脉造影结果分为冠心病组（n=164）与非冠心病组（n=126），对两组临床资料、检验指标、PCAT参数进行统计学分析。logistic回归分析筛选独立危险因素，构建列线图预测模型，绘制受试者操作特征曲线评估模型的区分度。采用限制性立方样条模型探讨冠状动脉周围脂肪衰减指数（FAI）与病变程度的关系。结果 冠心病组年龄、男性、糖尿病、N末端脑钠肽前体、超敏C反应蛋白、右冠状动脉周围FAI（RCA-FAI）、左前降支冠状动脉周围FAI（LAD-FAI）、左回旋支冠状动脉周围FAI（LCX-FAI）升高（P＜0.05），左前降支冠状动脉周围脂肪体积（LAD-PCAT体积）减低（P＜0.05）。多因素logistic回归提示年龄、男性、糖尿病及超敏C反应蛋白、RCA-FAI是诊断冠心病的独立危险因素（P＜0.05）。列线图模型显示RCA-FAI对冠心病的影响最大，AUC为0.931（95% CI 0.903~0.959）。限制性立方样条 模型提示RCA-FAI与冠状动脉病变程度呈倒“L”型相关，Gensini评分达47.93分后趋于平稳（P＜0.001）。结论 RCA-FAI是冠心病发生的预测因子，且对冠状动脉狭窄程度具有一定的预测作用。
Abstract:
Objective To investigate the value of pericoronary adipose tissue (PCAT) related parameters in predicting the severity of coronary artery disease. Methods A retrospective analysis was performed on 290 patients who underwent coronary CT angiography and coronary angiography in Fuwai Hospital of Chinese Academy of Medical Sciences and Rizhao people’s Hospital from March 2022 to August 2024. According to the angiography results ,the participants were divided into coronary heart disease (CHD) group (n=164) and non-CHD group (n=126). The general basic clinical data,laboratory indicators and PCAT parameters of patients were compared. Multivariate logistic regression analysis was conducted to screen out independent risk factors for predicting CHD,which were used to construct a nomogram to predict the occurrence of CHD. The receiver operating characteristic (ROC) curve was drawn to evaluate the differentiation of the models. Restricted cubic spline (RCS) was used to investigate the nonlinear relationship between fat attenuation index (FAI) around the coronary artery and the degree of coronary artery disease. Results Compared with non-CHD group,the age and proportion of male,diabetes,N-terminal pro-brain natriuretic peptide,high-sensitivity C-reactive protein ,FAI on the right coronary artery ( RCA-FAI),FAI on the left anterior descending artery ( LAD-FAI),FAI on the left circumflex ( LCX-FAI) were significantly increased in CHD group (all P＜0.05),and LAD-PCAT was significantly decreased (P＜0.05). Multiple logistic regression suggested that age,male,diabetes,high-sensitivity C-reactive protein,RCA-FAI were independent risk factors for CHD (P＜0.05). The area under the ROC curve of the nomogram was 0.931 (95% CI 0.903~0.959). RCS indicated that the RCA-FAI had an inverted L-shaped correlation with the severity of coronary artery lesions. After Gensini score reached 47.93,the trend tended to be stabilized (P＜0.001). Conclusions RCA-FAI is an independent risk factor for CHD and can predict the degree of coronary artery stenosis.

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更新日期/Last Update: 2025-06-26