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目的:探讨氟-18-脱氧葡萄糖（n 18F-FDG）正电子发射型计算机断层扫描（PET/CT）测量的左心房心外膜脂肪（LA-EAT）炎症活性与心房颤动（房颤）的相关性。n 方法:回顾性分析2018年3月至2019年12月因肿瘤指标异常升高或恶性肿瘤于苏州大学附属第三医院核医学科行n 18F-FDG PET/CT检查的78例房颤患者。按照PET/CT检查日期、年龄、性别等基本特征进行1∶1倾向性评分匹配，设立非房颤对照组（78例）。采用n 18F-FDG PET/CT测量左心房心外膜脂肪最大标准摄取值（LA-EAT FDG SUVn max）和总EAT体积（V-EAT），超声心动图获得左心室射血分数（LVEF）和左心房内径（LAD），并收集血脂和血炎症指标。比较房颤组和对照组患者临床资料及相关EAT指标的差异；采用多因素logistic回归分析房颤的相关因素；采用受试者工作特征（ROC）曲线及曲线下面积评估LA-EAT FDG SUVn max判断房颤的价值；采用ROC曲线寻找LA-EAT FDG SUVn max判断房颤的最佳界值并据其定义LA-EAT FDG SUVn max增高，单因素和多因素logistic回归分析LA-EAT FDG SUVn max增高与房颤的关系。n 结果:房颤组年龄（66.9±10.2）岁，男性55例（70.5%），对照组年龄（66.9±8.0）岁，男性52例（66.7%），两组的年龄、性别差异均无统计学意义（n P均>0.05）。房颤组的LAD［（44.2±5.8）mm比（35.4±4.4）mm］、V-EAT［（122.1±42.0）cmn 3比（91.6±34.5）cmn 3］、LA-EAT FDG SUVn max［（1.6±0.3）比（1.4±0.2）］均高于对照组，LVEF［（60.1±4.7）%比（63.9±2.9）%］低于对照组（n P均<0.001）。多因素logistic回归分析显示LAD（n OR=1.340，95%n CI 1.195~1.502）、V-EAT（n OR=1.016，95%n CI 1.001~1.031）、LA-EAT FDG SUVn max（n OR=1.375，95%n CI 1.095~1.723）与房颤正相关，LVEF（n OR=0.781，95%n CI 0.659~0.926）与房颤负相关（n P均<0.05）。LA-EAT FDG SUVn max判断房颤的ROC曲线下面积为0.680（95%n CI 0.597~0.764，n P0.05). The LAD ((44.2±5.8) mm vs. (35.4±4.4) mm), V-EAT ((122.1±42.0) cmn 3 vs. (91.6±34.5) cmn 3), and LA-EAT FDG SUVn max ((1.6±0.3) vs. (1.4±0.2)) values were significantly higher, while LVEF ((60.1±4.7)% vs. (63.9±2.9)%) was lower in the AF group than in the control group (n P all<0.001). Multivariate logistic regression analysis showed that LAD (n OR=1.340, 95%n CI 1.195-1.502), V-EAT (n OR=1.016, 95%n CI 1.001-1.031), and LA-EAT FDG SUVn max (n OR=1.375, 95%n CI 1.095-1.723) were positively correlated with AF, LVEF (n OR=0.781, 95%n CI 0.659-0.926) was negatively correlated with AF(n P all<0.05). The area under the ROC curve of LA-EAT FDG SUVn max for diagnosis of AF was 0.680 (95%n CI 0.597-0.764, n P<0.001), and the best cut-off value was 1.415 with a sensitivity of 65.4% and specificity of 61.5%. After adjusting for high-density lipoprotein cholesterol, LVEF, LAD and V-EAT, LA-EAT FDG SUVn max≥1.415 was independently associated with AF (n OR=2.982, 95%n CI 1.122-7.926, n P=0.010).n Conclusions:The inflammatory activity of LA-EAT measured by n 18F-FDG PET/CT is an independent risk factor of AF, and the increased inflammatory activity of LA-EAT is positively correlated with AF.n