Early diagnostic efficiency of coronary heart disease based on multi-slice spiral CT measurement of pericardial fat volume combined with lipoprotein α and apolipoprotein B detection
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摘要:
目的 探讨多层螺旋CT（MSCT）测量心周脂肪体积（PAT）联合脂蛋白α（Lp-α）、载脂蛋白B（Apo-B）检测在早期冠心病患者中的诊断评估价值。 方法 选取本院2020年3月~2022年4月收治的早期冠心病患者160例纳入观察组，再选取同期健康体检者110例为对照组，检测Lp-α、Apo-B水平及利用MSCT测量PAT，分析3项指标联合检测对冠心病的诊断评估价值。 结果 观察组PAT及Lp-α、水平均高于对照组（P < 0.05）；PAT及Lp-α、Apo-B水平与冠心病的发生呈正相关性（P < 0.05）；PAT及Lp-α、Apo-B水平与冠状动脉SYNTAX评分呈正相关性（P < 0.05）；ROC曲线显示：PAT及Lp-α、Apo-B联合诊断曲线下面积为0.920，高于各单项指标曲线下面积（P < 0.05）。 结论 PAT及Lp-α、Apo-B水平在冠心病早期患者中升高，与冠心病的发生和病情程度密切相关，并对冠心病具有较高的诊断价值。 Abstract:Objective To explore the diagnostic value of multi-slice spiral CT (MSCT) measurement of pericardial adipose tissue (PAT) combined with lipoprotein α (Lp-α) and apolipoprotein B (Apo-B) detection in patients with early coronary heart disease. Methods A total of 160 patients with early coronary heart disease who were treated in our hospital from March 2020 to April 2022 were selected as the observation group. The 110 healthy subjects were selected during the same period. We detected the levels of Lp-α and Apo-B, and used MSCT to measure PAT to analyze the value of the combined detection of these three indicators in the diagnosis and evaluation of coronary heart disease. Results The levels of PAT, Lp-α in the observation group were significantly higher than those in the control group (P < 0.05). Spearman correlation showed that the levels of PAT, Lp-α and Apo-B were positively correlated with the occurrence of coronary heart disease (P < 0.05). PAT, Lp-α, Apo-B levels were positively correlated with coronary SYNTAX score (P < 0.05). ROC curve showed that PAT, Lp-α, Apo-B levels combined diagnostic the area under the curve was 0.920, which was significantly higher than the area under the curve of each individual index (P < 0.05). Conclusion The PAT, Lp-α and Apo-B are elevated in patients with early coronary heart disease, which are closely related to the occurrence and severity of coronary heart disease. It has a high diagnostic value for coronary heart disease. -
图 1 冠心病患者CT影像学特征
Figure 1. CT imaging features of patients with coronary heart disease.
图 2 PAT及Lp-α、Apo-B水平对早期冠心病的诊断价值
Figure 2. The diagnostic value of PAT and Lp-α and Apo-B levels for early coronary heart disease.
表 1 两组患者PAT及Lp-α、Apo-B水平比较
Table 1. Comparison of PAT, LP-α and Apo-B of two groups (Mean±SD)
组别 PAT（cm3） Lp-α（ng/mL） Apo-B（g/L） 观察组（n=160） 183.87±27.84 22.60±6.09 0.91±0.24 对照组（n=110） 149.37±17.10 15.56±3.26 0.65±0.19 t 11.58 11.086 9.465 P < 0.001 < 0.001 < 0.001 PAT: 心周脂肪组织; Lp-α: 脂蛋白α; Apo-B: 载脂蛋白B 
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表 2 PAT及Lp-α、Apo-B水平与冠心病的相关性
Table 2. Correlation between PAT and Lp-α, Apo-B levels with coronary heart disease
指标 r P PAT 0.572 < 0.001 Lp-α 0.592 < 0.001 Apo-B 0.513 < 0.001
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表 3 PAT及Lp-α、Apo-B水平与冠状动脉SYNTAX评分的关系
Table 3. Correlation between PAT and Lp- α and Apo- B levels and coronary SYNTAX scores
指标 r P PAT 0.544 < 0.001 Lp-α 0.454 < 0.001 Apo-B 0.505 < 0.001
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表 4 PAT及Lp-α、Apo-B水平对早期冠心病的诊断价值
Table 4. The diagnostic value of PAT and Lp-α and Apo-B levels for early coronary heart disease.
指标 曲线下面积 最佳截断值 敏感度 特异性 95% CI 约登指数 PAT 0.836* 169.81 cm3 0.706 0.882 0.789~0.883 0.588 Lp-α 0.848* 18.670 ng/mL 0.744 0.873 0.802~0.894 0.617 Apo-B 0.801* 0.84 g/L 0.594 0.864 0.750~0.852 0.458 联合诊断 0.92 - 0.838 0.927 0.887~0.952 0.765 *P < 0.05 vs联合诊断.
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