心外膜脂肪定量及脂肪因子水平与冠脉粥样硬化斑块易损性的相关性研究
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摘要
目的观察冠心病(CHD)患者心外膜脂肪体积(EATV)及脂肪因子水平,并分析其与冠脉粥样硬化斑块易损性的关系。方法选取2015年1月～2017年12月崇左市人民医院收治的100例CHD患者为CHD组,50例健康人为对照组。比较两组EATV、冠脉狭窄程度(Gensini积分)、正性重构率及软斑块率,血清脂联素、抵抗素、内脂素水平;分析出现易损性动脉粥样硬化斑块的危险因素。结果 CHD组EATV、Gensini积分、正性重构率均高于对照组(P <0.01),血清脂联素水平低于对照组(P <0.01),血清抵抗素、内脂素水平均高于对照组(P <0.01);EATV>107.20 cm~3、血清脂联素<2.90μg/mL、血清抵抗素>11.39 ng/mL、血清内脂素>32.50 ng/mL、高血压均是出现易损性冠脉粥样硬化斑块的独立危险因素(P <0.01)。结论 CHD患者EATV及脂肪因子水平均有明显异常,且出现易损性冠脉粥样硬化斑块的危险因素较多,需据此制定防控对策。
Objective To observe the epicardial adipose tissue volume(EATV) and the levels of adiponectin in patients with coronary heart disease(CHD), and analyze the relationship with the vulnerability of coronary atherosclerotic plaques.Methods From January 2015 to December 2017, in Chongzuo People's Hospital, 100 patients with coronary heart disease were selected as CHD group, and 50 healthy people were selected as control group. The EATV, coronary artery stenosis(Gensini integral) and positive reconstruction rate the serum levels of adiponectin, resistin and visfatin in two groups were compared, the related risk factors of the vulnerability of coronary atherosclerotic plaques were analyzed.Results The EATV, the Gensini integral and the positive reconstruction rate of the CHD group were higher than the control group(P < 0.01). The serum level of adiponectin of the CHD group was lower than the control group(P < 0.01),the levels of serum resistin and visfatin of the CHD group were higher than the control group(P < 0.01). The EATV> 107.20 cm3, the serum level of adiponectin < 2.90 μg/mL, the serum level of resistin > 11.39 ng/mL, the serum level of visfatin > 32.50 ng/mL, hypertension were independent risk factors for vulnerable coronary atherosclerotic plaques(P <0.01). Conclusion The levels of EATV and adipose factors in CHD patients are obviously abnormal, and there are many risk factors for vulnerable atherosclerotic plaque, and the prevention and control measures should be formulated accordingly.
Objective To observe the epicardial adipose tissue volume(EATV) and the levels of adiponectin in patients with coronary heart disease(CHD), and analyze the relationship with the vulnerability of coronary atherosclerotic plaques.Methods From January 2015 to December 2017, in Chongzuo People's Hospital, 100 patients with coronary heart disease were selected as CHD group, and 50 healthy people were selected as control group. The EATV, coronary artery stenosis(Gensini integral) and positive reconstruction rate the serum levels of adiponectin, resistin and visfatin in two groups were compared, the related risk factors of the vulnerability of coronary atherosclerotic plaques were analyzed.Results The EATV, the Gensini integral and the positive reconstruction rate of the CHD group were higher than the control group(P < 0.01). The serum level of adiponectin of the CHD group was lower than the control group(P < 0.01),the levels of serum resistin and visfatin of the CHD group were higher than the control group(P < 0.01). The EATV> 107.20 cm3, the serum level of adiponectin < 2.90 μg/mL, the serum level of resistin > 11.39 ng/mL, the serum level of visfatin > 32.50 ng/mL, hypertension were independent risk factors for vulnerable coronary atherosclerotic plaques(P <0.01). Conclusion The levels of EATV and adipose factors in CHD patients are obviously abnormal, and there are many risk factors for vulnerable atherosclerotic plaque, and the prevention and control measures should be formulated accordingly.
引文
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[15]李俊伟,夏寒冰,赵红丽,等.基于超声测量的心外膜脂肪组织厚度预测冠心病的价值[J].诊断学理论与实践,2017,17(3):324-327.
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[17]闫伟,阎娇娟,王有恒,等.冠心病患者血浆HO-1、IL-6及内脂素水平与冠状动脉病变严重程度相关性研究[J].陕西医学杂志,2017,46(5):604-608.
[18]王婷,夏大胜,何强,等.心绞痛患者血清内脂素水平变化与激活蛋白-1、基质金属蛋白酶-2的关系[J].山东医药,2016,56(5):1-3.
[19]孙金栋,袁红,於华敏,等.冠心病合并代谢综合征患者脂联素水平与炎症因子及冠状动脉病变的关系[J].中华全科医学,2016,14(6):918-920.
[20]周亮亮,宫剑滨,李德闽,等.心外膜脂肪定量及其炎症状态与冠状动脉粥样硬化斑块易损性的关系[J].中华心血管病杂志,2015,43(2):134-140.
[2]宋如莹,丁润涛,崔文.心肌梗死和心脏传导系统病变在心源性猝死中的作用[J].法医学杂志,2017,33(2):171-174.
[3]王旖旎,林平,高学琴,等.基于OCT的冠状动脉粥样硬化斑块稳定性影响因素的分析[J].临床心血管病杂志,2016,32(9):886-889.
[4]杜俣,吉庆伟,王志坚,等.心外膜脂肪组织与冠状动脉粥样硬化性心脏病关系及其机制的研究进展[J].临床心血管病杂志,2016,32(4):324-327.
[5]Erkan AF,Tanindi A,Kocaman SA,et al.Epicardial adipose tissue thickness is an independent predictor of critical and complex coronary artery disease by gensini and syntax scores[J].Tex Heart Inst J,2016,43(1):29-37.
[6]吴启源,袁明远,许建荣,等.双源CTA对冠状动脉临界狭窄病变斑块判断的价值[J].中国医学计算机成像杂志,2017,23(3):217-221.
[7]李岳军,闫继锋.双源CT与冠状动脉血管内超声评估冠状动脉粥样硬化斑块价值的对照研究[J].中华实用诊断与治疗杂志,2016,30(5):463-466.
[8]Dweck MR,Doris MK,Motwani M,et al.Imaging of coronary atherosclerosis[mdash]evolution towards new treatment strategies[J].Nat Rev Cardiol,2016,13(9):46-49.
[9]李琛,周文锐,朱敏洁.冠心病患者心外膜脂肪组织厚度与颈动脉弹性的相关性研究[J].临床和实验医学杂志,2016,15(10):967-969.
[10]张文艳,李健,周蕊,等.心外膜脂肪组织体积与零钙化积分冠状动脉斑块的关系[J].实用放射学杂志,2016,32(3):411-413.
[11]谭强,王庆胜,杨红梅,等.血管内超声及虚拟组织学评估冠状动脉血管重构与斑块成分的关系[J].中国动脉硬化杂志,2016,24(11):1119-1122.
[12]陈炽华,杨文洁,严福华.内脏脂肪体积及常见肥胖指标与非酒精性脂肪肝的相关性研究[J].放射学实践,2017,32(5):436-440.
[13]Lu MT,Park J,Ghemigian K,et al.Epicardial and paracardial adipose tissue volume and attenuation-Association with high-risk coronary plaque on computed tomographic angiography in the ROMICATⅡtrial[J].Atherosclerosis,2016,251:47-54.
[14]孟祥彬,王文尧,张阔,等.社区人群心外膜脂肪体积与冠心病危险因素和冠状动脉钙化积分的关系[J].中国循环杂志,2017,32(1):142-144.
[15]李俊伟,夏寒冰,赵红丽,等.基于超声测量的心外膜脂肪组织厚度预测冠心病的价值[J].诊断学理论与实践,2017,17(3):324-327.
[16]Gencer B,Auer R,De RN,et al.Association between resistin levels and cardiovascular disease events in older adults:The health,aging and body composition study[J].Atherosclerosis,2016,245(222):181-187.
[17]闫伟,阎娇娟,王有恒,等.冠心病患者血浆HO-1、IL-6及内脂素水平与冠状动脉病变严重程度相关性研究[J].陕西医学杂志,2017,46(5):604-608.
[18]王婷,夏大胜,何强,等.心绞痛患者血清内脂素水平变化与激活蛋白-1、基质金属蛋白酶-2的关系[J].山东医药,2016,56(5):1-3.
[19]孙金栋,袁红,於华敏,等.冠心病合并代谢综合征患者脂联素水平与炎症因子及冠状动脉病变的关系[J].中华全科医学,2016,14(6):918-920.
[20]周亮亮,宫剑滨,李德闽,等.心外膜脂肪定量及其炎症状态与冠状动脉粥样硬化斑块易损性的关系[J].中华心血管病杂志,2015,43(2):134-140.