冠状动脉周围脂肪参数与老年冠心病病人动脉斑块稳定性的关系

doi:10.3969/j.issn.1003-9198.2025.01.015

摘要/Abstract

摘要： 目的探究冠状动脉周围脂肪(PCAT)相关参数与老年CHD病人冠状动脉斑块稳定性的关系。方法选取2021—2022年在遂宁市中心医院接受治疗的老年CHD病人135例作为研究对象,对病人进行CT血管造影(CTA)检查,将冠状动脉斑块稳定的病人划分至稳定组,将冠状动脉斑块不稳定的病人划分至不稳定组。收集并比较2组病人一般资料、PCAT体积、冠状动脉周围脂肪密度(FAI),采用Logistic回归分析导致老年CHD病人冠状动脉斑块不稳定的因素,并绘制ROC曲线,探讨各影响因素对老年CHD病人冠状动脉斑块不稳定的预测价值。结果 30例老年CHD病人冠状动脉斑块不稳定,纳入不稳定组(n=30),其余为稳定组(n=105)。2组病人PCAT体积、FAI比较差异有统计学意义(P＜0.01);Logistic回归分析结果显示,PCAT体积、FAI为老年CHD病人冠状动脉斑块不稳定的危险因素,其预测冠状动脉斑块不稳定的AUC分别为0.829、0.814,灵敏度为0.867、0.700,特异度为0.686、0.838,最佳阈值为63.050 cm³、-76.620 HU。结论老年CHD病人冠状动脉斑块不稳定的影响因素为PCAT体积、FAI,两者对老年CHD病人冠状动脉斑块不稳定具有较高的预测价值。

关键词: 冠状动脉周围脂肪, 冠心病, 冠状动脉斑块, 稳定性

Abstract: Objective To investigate the relationship between pericoronary adipose tissue(PCAT)-related parameters and coronary plaque stability in the elderly patients with coronary heart disease (CHD). Methods A total of 135 elderly patients with CHD admitted to Suining Central Hospital from January 2021 to December 2022 were enrolled in this study. All patients received CT angiography (CTA) detection. According to the CTA results, the patients were divided into stable group (with stable plaque) and unstable group (with unstable plaque). The general data, PCAT volume and peri-coronary fat density (FAI) of the two groups were collected and compared. Logistic regression analysis was used to analyze the influencing factors of coronary plaque instability, and the receiver operating characteristic (ROC) curve was drawn to observe the predictive value of each factor for coronary plaque instability in the elderly patients with CHD. Results A total of 30 elderly CHD patients presenting with unstable coronary artery plaque were enrolled in the unstable group (n=30), and 105 patients with stable coronary artery plaque were enrolled in the stable group (n=105). There were significant differences in PCAT volume and FAI between the two groups (P<0.01). Logistic regression analysis showed that PCAT volume and FAI were risk factors of coronary plaque stability in the elderly patients with CHD. The areas under the curve (AUC) of PCAT volume and FAI in predicting plaque instability were 0.829, 0.814, with the sensitivity of 0.867, 0.700, and the specificity of 0.686, 0.838,respectively.And the optimal threshold was 63.050 cm³ and -76.620 HU. Conclusions PCAT volume and FAI are the influencing factors of coronary plaque instability in the elderly patients with CHD, and both indexes have high predictive value for the occurrence of coronary plaque instability.

Key words: pericoronary adipose tissue, coronary heart disease, coronary plaque, stability

中图分类号:

R 541.4

黄建梅, 郑永. 冠状动脉周围脂肪参数与老年冠心病病人动脉斑块稳定性的关系[J]. 实用老年医学, 2025, 39(1): 66-69.

HUANG Jianmei, ZHENG Yong. Relationship between pericoronary adipose tissue-related parameters and plaque stability in elderly patients with coronary heart disease[J]. Practical Geriatrics, 2025, 39(1): 66-69.

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