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目的:评价经胸超声心动图测量心外膜脂肪(EAT)厚度与冠心病的相关性和预测价值。方法:150例住院患者经冠状动脉(冠脉)造影分为冠心病组(100例)和非冠心病组(50例)。经胸超声心动图测量EAT厚度,并比较两组临床资料及EAT厚度的差异。利用Logistic回归模型和ROC曲线分析EAT厚度与冠心病的关系及诊断价值。结果:冠心病组EAT厚度中位数为4.78(3.75~6.47)mm,明显高于非冠心病组3.43(2.97~4.10)mm(P<0.001)。Logistic回归分析显示,除了合并糖尿病、BMI≥25之外,EAT厚度(OR=3.966,95%CI:1.234~12.743,P=0.021)也是冠心病的一个独立危险因素。EAT厚度≥4.61 mm诊断冠心病的敏感性为58%,特异性为86%,ROC曲线下面积为0.766(95%CI:0.690~0.842,P<0.001)。结论:经胸超声心动图测量的EAT厚度与冠心病发生密切相关,可作为冠心病筛查的一种有效的无创检查方法。
Objective: To evaluate the correlation and predictive value of transthoracic echocardiography in measuring the thickness of epicardial fat (EAT) and coronary heart disease. Methods: 150 hospitalized patients were divided into coronary heart disease group (100 cases) and non - coronary heart disease group (50 cases) by coronary artery angiography. ETH thickness was measured by transthoracic echocardiography, and the differences of clinical data and EAT thickness were compared between the two groups. Logistic regression model and ROC curve analysis of the relationship between EAT thickness and coronary heart disease and its diagnostic value. Results: The median thickness of EAT in CHD group was 4.78 (3.75 ~ 6.47) mm, which was significantly higher than that in non-CHD group (3.97 ~ 2.10 mm) (P <0.001). Logistic regression analysis showed that the thickness of EAT (OR = 3.966,95% CI: 1.234 ~ 12.743, P = 0.021) was also an independent risk factor for CHD in patients with diabetes and BMI≥25. The EAT thickness was ≥4.61 mm with a sensitivity of 58% and a specificity of 86%. The area under the ROC curve was 0.766 (95% CI: 0.690-0.842, P <0.001). Conclusion: The thickness of EAT measured by transthoracic echocardiography is closely related to the occurrence of coronary heart disease, which can be used as an effective noninvasive detection method for coronary heart disease screening.