血管斑块特征及脂肪衰减指数对冠心病心肌缺血的预测价值

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[关键词]体层摄影术，X线计算机;血流储备分数;脂肪衰减指数;心肌缺血；冠心病 [中图分类号]R814.42；R541.4 [文献标识码］A DOI：10.3969/j.issn.1672-0512.2026.01.014

Predictive valueof plaquecharacteristicsandfatatenuation index for myocardial ischemia in coronary heart disease HAO Xiuxiu，LI Xu，YU Guanghai，HU Xiankuo，ZHANG Lei，YUAN Yushan，ZHANG Yang

DepartmentofedicalImaging，yangHspitalfliatedtoengbuedicalUniversityuyangeople'sspitaluyang ，China.

[Abstract]Objective：Toexplorethepredictivevalueof plaquecharacteristcsandpericoronalfatatenuationindex（FAI）inthe diagnosisofmyocardialischemiaincoronaryheartdisease.Methods：Aretrospectiveanalysiswasperformedon265patients withcoronaryheartdisease（398coronaryarteries）．Andtheplaquecharacteristics，theproximalFAIofthethreemain coronaryarteriesandCTfractionalflowreserve（CT-FFR）weremeasured.Thepatientsweredividedintothemyocardial ischemiagroup（91cases，CT-FFR≤0.8）andnon-myocardial ischemiagroup（174cases，CT-FFR>0.8）acording to CT-FFR values.Logisticregresionanalysiswasusedtoevaluatetheindependentpredictorsofmyocardialischemiaincoronaryheart disease.TheROCcurveswereplotedtoanalyze theperformanceoftheindependentpredictorsonmyocardialischemiain coronaryheartdisease.Results：Therewasastatisicallysignificantdiferenceintheproportionofdiabetesbetweenthe wo groups （ P<0.05 ）.The myocardial ischemia group showed a longer lesion，more severe degreeof coronary artery stenosis，more obviousdegreeofthepositiveremodeling，largervolumeofplaqueandcalcification，alargerFAI，andalargerproportion oflow-density plaques compared to the non-myocardial ischemia group（all P<0.05 ）.Univariate and multivariate logistic regresionanalysisrevealedthatdiabetes，degreeofcoronaryarterystenosisandFAIweretheindependentpredictorsof myocardial ischemia in coronary heart disease （all P<0.05 ）. ROC curve analysis showed that the AUC values for diagnosing myocardialischemiaincoronaryheartdiseasebydiabetesdegreeofcoronaryarterystenosisandFAIwereO.564，0.812and 0.708，respectively，andtheAUCforthecombineddiagnosiswasO.85o.Conclusion：Diabetesmelitus，stenosisdegreendFAI have good predictive value in the diagnosis of myocardial ischemia in coronary heart disease.

[Key words]Tomography，X-raycomputed;Fraction flowreserve;Fatatenuationindex;Myocardialischemia;Coronarydisease

我国冠状动脉粥样硬化性心脏病（冠心病）患者约1100多万，且死亡率逐年上升[1]。（剩余7345字）