作者：琚炜，张平洋，胡庆兰，李妙

单位：

1.210000江苏省南京市，南京医科大学附属南京医院 南京市第一医院心血管超声科　2.241000安徽省芜湖市，安徽省皖南康复医院超声医学科

单位（英文）：

1.Cardiovascular Ultrasound Department, Nanjing Medical University Affiliated Nanjing Hospital/Nanjing First Hospital,Nanjing 210000, China2.Ultrasound Medicine Department, Anhui Wannan Rehabilitation Hospital, Wuhu 241000, China

关键词：

冠心病；心外膜脂肪组织厚度；小而密的低密度脂蛋白；冠状动脉狭窄

关键词（英文）：

Coronary disease; Epicardial adipose tissue thickness; Small and dense low density lipoprotein; Coronaryartery stenosis

中图分类号：

R 541.4

DOI：

10.12114/j.issn.1008-5971.2023.00.218

基金项目：

江苏省卫生健康委科研重点项目（ZD2021048）

摘要：

　目的　探讨心外膜脂肪组织（EAT）厚度及血清小而密的低密度脂蛋白（sd-LDL）水平对冠心病的诊断价值。方法　选取2020年6月至2022年6月南京医科大学附属南京医院收治的冠心病患者90例，根据冠状动脉造影（CAG）检查结果将患者分为轻度组（20例）、中度组（38例）和重度组（32例）；另选取同期在本院体检的健康者40例作为对照组。比较四组EAT厚度、血清sd-LDL水平，采用Pearson相关分析探讨EAT厚度、血清sd-LDL水平与冠心病患者冠状动脉狭窄率的相关性；绘制ROC曲线以评估EAT厚度、血清sd-LDL水平及二者联合诊断冠心病的价值。结果　轻度组、中度组及重度组EAT厚度、血清sd-LDL水平高于对照组，中度组、重度组EAT厚度、血清sd-LDL水平高于轻度组，重度组EAT厚度、血清sd-LDL水平高于中度组（P＜0.05）。Pearson相关分析结果显示，EAT厚度、血清sd-LDL水平与冠心病患者冠状动脉狭窄率呈正相关（r=0.336，P＜0.01；r=0.401，P＜0.01）。ROC曲线分析结果显示，EAT厚度、血清sd-LDL水平诊断冠心病的曲线下面积分别为0.827〔95%CI（0.708，0.913）〕、0.878〔95%CI（0.767，0.948）〕，二者联合诊断冠心病的曲线下面积为0.927〔95%CI（0.830，0.978）〕。结论　冠心病患者EAT厚度增厚、血清sd-LDL水平升高，且EAT厚度、血清sd-LDL水平与冠状动脉狭窄率呈正相关，二者联合对冠心病有较高诊断价值。

英文摘要：

Objective To investigate the diagnostic value of epicardial adipose tissue (EAT) thickness and serumsmall and dense low density lipoprotein (sd-LDL) level for coronary heart disease. Methods A total of 90 coronary heartdisease patients who admitted to the Nanjing Medical University Affiliated Nanjing Hospital from June 2020 to June 2022 wereselected and divided into mild group (20 cases) , moderate group (38 cases) and severe group (32 cases) according to the results ofcoronarography (CAG) . Another 40 healthy individuals who underwent physical examination during the same period at the samehospital were selected as the control group. EAT thickness and serum sd-LDL level were compared among four groups. Pearsoncorrelation analysis was used to analyze the correlation between EAT thickness, serum sd-LDL level and coronary artery stenosisrate in patients with coronary heart disease. ROC curve was used to analyze the value of EAT thickness, serum sd-LDL level andtheir combination in diagnosing coronary heart disease. Results The EAT thickness and serum sd-LDL level in the mild group,moderate group and severe group were higher than those in the control group, the EAT thickness and serum sd-LDL level in themoderate group and severe group were higher than those in the mild group, the EAT thickness and serum sd-LDL level in thesevere group were higher than those in the moderate group (P < 0.05) . The results of Pearson correlation analysis showed EATthickness, serum sd-LDL level were positively correlated with coronary artery stenosis rate in patients with coronary heart disease(r=0.336, P < 0.01; r=0.401, P < 0.01) . The results of ROC curve analysis showed that the AUC of EAT thickness and serum sdLDL level in diagnosing coronary heart disease was 0.827 [95%CI (0.708, 0.913) ] and 0.878 [95%CI (0.767, 0.948) ] respectively, and the AUC of their combination in diagnosing coronary heart disease was 0.927 [95%CI (0.830, 0.978) ] . Conclusion EATthickness and serum sd-LDL level increase in patients with coronary heart disease. EAT thickness and serum sd-LDL level arepositively correlated with coronary artery stenosis rate, and their combination has high diagnostic value for coronary heart disease.

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