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目的探讨冠心病患者腹部内脏脂肪厚度(VFT)与冠状动脉狭窄的关系。方法选择2007年9月至2009年1月在广西医科大学第五临床医院行冠状动脉造影的216例患者,其中冠心病148例,记录身高、体重、腰围、血压等,检测血脂、空腹血糖、尿酸、肾功能等指标,对冠状动脉狭窄程度进行定量Gensi-ni积分,同时应用超声测量VFT,根据VFT值将患者分为低、中、高值3组。结果与低值组比较,中、高值组患者腰围、体重指数较大,高血压、糖尿病比例高(P<0.05),三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)明显增高,高密度脂蛋白胆固醇(HDL-C)显著降低。VFT与年龄、腰围、体质量指数、TG、LDL-C呈正相关,与HDL-C呈负相关。随着VFT值增加,Gensini积分明显增大。Logistic回归分析显示年龄、TG、低HDL-C、糖尿病和VFT是冠心病的独立危险因素,校正腰围后VFT的OR值有所减小,但差异仍有统计学意义。结论冠心病患者VFT与冠状动脉狭窄严重程度呈明显正相关,VFT测量可以作为冠心病患者危险评估的有用指标。
Objective To investigate the relationship between abdominal visceral fat thickness (VFT) and coronary artery stenosis in patients with coronary heart disease. Methods From September 2007 to January 2009, 216 patients undergoing coronary angiography at the Fifth Clinical Hospital of Guangxi Medical University were enrolled. Among them, 148 cases were coronary heart disease. Height, weight, waist circumference and blood pressure were recorded. Serum lipids, fasting blood glucose, Uric acid, renal function and other indicators, the degree of coronary artery stenosis Gensi-ni score, while the application of ultrasound measurement VFT, according to the VFT value will be divided into low, medium and high value 3 groups. Results Compared with the low-value group, the waist-circumference and body mass index were higher in middle-high-value group, the proportion of hypertension and diabetes was higher (P <0.05), the triglyceride (TG) and low-density lipoprotein cholesterol Increased, high-density lipoprotein cholesterol (HDL-C) was significantly reduced. VFT was positively correlated with age, waist circumference, body mass index, TG and LDL-C, but negatively correlated with HDL-C. Gensini scores increased significantly as VFT values increased. Logistic regression analysis showed that age, TG, low HDL-C, diabetes mellitus and VFT were the independent risk factors for coronary heart disease. The corrected VRS after waist circumference was decreased, but the difference was still statistically significant. Conclusion There is a positive correlation between VFT and the severity of coronary artery stenosis in patients with coronary heart disease. VFT can be used as a useful indicator of risk assessment in patients with coronary heart disease.