探讨心外膜脂肪厚度、CT值及心脏外科与介入治疗狭窄冠脉研究(Syntax)评分与冠心病的关系。

选取2017年2月至2018年10月就诊于临沂市兰陵县人民医院心血管内科，经冠状动脉造影检查确诊的冠心病患者，共69例作为研究组，另选同期正常健康体检者60例作为对照组。两组均行冠状动脉CT血管成像(CTA)检查，比较心外膜脂肪厚度及CT值。分析冠心病患者造影结果，计算Syntax评分，比较不同水平Syntax评分冠心病患者心外膜脂肪厚度及CT值差异。

研究组患者甘油三酯[(1.62±0.68)mmol/L]、总胆固醇[(5.12±1.83)mmol/L]水平明显高于对照组[(1.50±0.53)mmol/L，(4.90±1.20)mmol/L](t＝4.60，3.82；均P<0.05)；研究组高密度脂蛋白胆固醇[(1.49±0.43)mmol/L]和低密度脂蛋白胆固醇[(2.45±0.63)mmol/L]水平与对照组[(1.50±0.55)mmol/L，(2.50±0.55)mmol/L]比较，均差异无统计学意义(t＝0.55，0.34；均P>0.05)。研究组心外膜脂肪厚度[(12.30±2.66)mm]高于对照组[(9.50±1.85)mm](t＝8.60，P<0.01)；研究组心外膜脂肪CT值[(-98.60±15.66)HU]高于对照组[(-70.55±9.82)HU](t＝19.36，P<0.01)；低积分组冠心病患者心外膜脂肪厚度[(11.30 ± 2.20)mm]、心外膜脂肪CT值[(-90.60±9.55)HU]、平均Syntax评分[(-17.32±8.42)分]低于高积分组冠心病患者[(14.50±2.76)mm、(-115.30±13.36)HU、(-30.44±9.19)分]，均差异有统计学意义(t＝6.42，9.58，21.15；均P<0.01)。

心外膜脂肪厚度、CT值可能影响冠心病患者Syntax评分结果，可作为患者病情评估的参考指标，有推广价值。

To investigate the relationship between epicardial fat thickness, CT value, the scores of synergy between percutaneous coronary intervention with TAXUSTM and cardiac surgery (Syntax score) and coronary artery disease.

From February 2017 to October 2018, patients in Cardiology Department of Lanling People′s Hospital were selected. A total of 69 patients with coronary artery disease diagnosed by coronary angiography were enrolled in the study group, 60 persons with normal physical examination were selected as the control group.All cases underwent coronary CT angiography (CTA) examination, epicardial fat thickness and CT value were compared between the two groups. To compare the differences in epicardial fat thickness and CT values with different Syntax scores according to coronary angiography between the two groups.

The levels of triglyceride [(1.62±0.68)mmol/L] and total cholesterol [(5.12±1.83)mmol/L] in the study group were significantly higher than those in the control group [(1.50±0.53), (4.90±1.20)mmol/L] (t=4.60, 3.82, all P<0.05). For the levels of high-density lipoprotein and low-density lipoprotein cholesterol, there were no significant differences between the study group [(1.49±0.43)mmol/L, (2.45±0.63)mmol/L] and the control group [(1.50±0.55)mmol/L, (2.50±0.55)mmol/L] (t=0.55, 0.34, all P>0.05). The epicardial fat thickness of the study group [(12.30±2.66)mm] was higher than that of the control group [(9.50±1.85)mm] (t=8.60, P<0.01). The epicardial fat CT value [(-98.60±15.66)HU] in the study group was higher than that in the control group [(-70.55±9.82)HU] (t=19.36, P<0.01). Epicardial fat thickness [(11.30±2.20)mm], epicardial fat CT value [(-90.60±9.55)HU] and the average Syntax score [(-17.32±8.42)point] in patients with low score group were lower than those in the high score group [(14.50±2.76)mm, (-115.30±13.36)HU, (-30.44±9.19) point], the differences were statistically significant (t=6.42, 9.58, 21.15, all P<0.01).

Epicardial fat thickness and CT value may affect the Syntax score of patients with coronary heart disease, which can be used as a reference index for disease evaluation, and it has a promotional value.