冠状动脉左前降支心肌桥与其近端周围脂肪组织参数的相关性

doi:10.3969/j.issn.1004-583X.2026.04.003

摘要/Abstract

摘要：

目的通过冠状动脉CT血管造影检查,观察左前降支(left anterior descending,LAD)浅表型心肌桥与其近端周围脂肪组织参数的相关性。方法纳入2023年5月-2025年9月就诊于新疆生产建设兵团第五师医院,经冠状动脉CT血管造影检查冠状动脉未见斑块,临床疑诊冠状动脉粥样硬化性心脏病患者295例。根据左前降支有无心肌桥(myocardial bridge,MB)将其分为MB组(n=134)和无MB组(n=161)。比较两组性别、年龄、体质量指数、脂肪衰减指数(fat attenuation index,FAI)和脂肪总体积(fat volume,FV)。采用多元线性回归分析探究MB组性别、年龄、体质量指数和左前降支心肌桥(left anterior descending-myocardial bridge,LAD-MB)长度是否对其近端周围脂肪组织FAI和FV有影响。结果与无MB组相比,MB组FAI增高、FV降低(P<0.01)。多元线性回归分析显示,MB组LAD-MB长度对FAI有影响(P<0.05),年龄、性别、体质量指数均对FAI无影响(P>0.05);年龄、性别、体质量指数、LAD-MB长度均对FV无影响(P>0.05)。结论 FAI、FV可作为评估MB相关血管炎症的潜在影像学生物标志物。

关键词: 心肌桥, 左前降支, 周围脂肪组织, 冠状动脉CT血管造影

Abstract:

Objective To investigate the correlation between superficial myocardial bridge (MB) of the left anterior descending artery (LAD) and parameters of its proximal perivascular adipose tissue using coronary CT angiography. Methods A total of 295 patients clinically suspected of coronary atherosclerotic heart disease who underwent coronary CT angiography at the Fifth Division Hospital of Xinjiang Production and Construction Corps between May 2023 and September 2025 were enrolled. No coronary plaques were detected on CT angiography. According to the presence or absence of MB in the LAD, the patients were divided into an MB group (n=134) and a non-MB group (n=161). Sex, age, body mass index, fat attenuation index (FAI), and fat volume (FV) were compared between the two groups. Multiple linear regression was used to determine whether sex, age, body mass index, and left anterior descending-myocardial bridge (LAD-MB) length affected proximal perivascular adipose tissue FAI and FV in the MB group. Results Compared with the non-MB group, the MB group had higher FAI and lower FV (P<0.01). Multiple linear regression analysis showed that LAD-MB length was associated with FAI in the MB group (P<0.05), whereas age, sex, and body mass index were not (P>0.05). Age, sex, body mass index, and LAD-MB length were not associated with FV (P>0.05). Conclusion FAI and FV may serve as potential imaging biomarkers for assessing MB-related vascular inflammation.

Key words: myocardial bridging, left anterior descending, surrounding adipose tissue, coronary CT angiography

中图分类号:

R541.1

丁秋分, 杨镇宇, 李翠芹, 王俭. 冠状动脉左前降支心肌桥与其近端周围脂肪组织参数的相关性[J]. 临床荟萃, 2026, 41(4): 307-311.

Ding Qiufen, Yang Zhenyu, Li Cuiqin, Wang Jian. Correlation between myocardial bridge of the left anterior descending coronary artery and parameters of its proximal perivascular adipose tissue[J]. Clinical Focus, 2026, 41(4): 307-311.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.04.003

https://www.lchc.cn/CN/Y2026/V41/I4/307

图/表 6

图1 CTA测量 LAD-MB相关参数及选择近端周围脂肪组织的ROI示意图 a.拉直图像LAD-MB长度; b.曲面图像LAD和FAI、FV; c.轴面图像LAD和FAI、FV; d.多个轴向平面图像FAI、FV的测量; e.在直线视图中测量自LAD初始点长约40 mm的血管区段的FAI、FV

Fig.1 Schematic diagram of CTA measurement of LAD-MB-related parameters and selection of the region of interest in proximal perivascular adipose tissue a. Straightened image showing LAD-MB length; b. Curved image showing LAD and measurement of FAI and FV; c. Axial image showing LAD and measurement of FAI and FV; d. Measurement of FAI and FV on multiple axial planes; e. Measurement of FAI and FV in the vascular segment approximately 40 mm from the starting point of the LAD in the straightened view

表1 两组临床资料比较

Tab.1 Comparison of clinical characteristics between the two groups

组别	例数	男性[例(%)]	年龄(岁)	体质量指数(kg/m²)	FAI(HU)	FV(mm³)
MB组	134	70(52.2)	54.840±10.302	26.920±2.839	-77.226±15.834	938.312±207.100
无MB组	161	78(48.4)	54.950±8.679	27.040±3.601	-83.107±7.332	1 228.513±350.473
χ²/ $t$ 值		0.421	-0.104	-0.315	-4.203	-8.436
$P$ 值		0.517	0.918	0.753	<0.01	<0.01

表1 两组临床资料比较

Tab.1 Comparison of clinical characteristics between the two groups

组别	例数	男性[例(%)]	年龄(岁)	体质量指数(kg/m²)	FAI(HU)	FV(mm³)
MB组	134	70(52.2)	54.840±10.302	26.920±2.839	-77.226±15.834	938.312±207.100
无MB组	161	78(48.4)	54.950±8.679	27.040±3.601	-83.107±7.332	1 228.513±350.473
χ²/ $t$ 值		0.421	-0.104	-0.315	-4.203	-8.436
$P$ 值		0.517	0.918	0.753	<0.01	<0.01

表2 MB组FAI影响因素的多元线性回归分析

Tab. 2 Multiple linear regression analysis of factors influencing FAI in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	-87.069	-105.244~-68.894	-9.479	0.000
年龄	0.083	0.064	-0.072~0.200	0.934	0.352
性别	0.028	0.455	-2.425~3.334	0.313	0.755
体质量指数	-0.006	-0.016	-0.536~0.505	-0.060	0.952
LAD-MB长度	0.184	0.201	0.012~0.390	2.105	0.037

表2 MB组FAI影响因素的多元线性回归分析

Tab. 2 Multiple linear regression analysis of factors influencing FAI in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	-87.069	-105.244~-68.894	-9.479	0.000
年龄	0.083	0.064	-0.072~0.200	0.934	0.352
性别	0.028	0.455	-2.425~3.334	0.313	0.755
体质量指数	-0.006	-0.016	-0.536~0.505	-0.060	0.952
LAD-MB长度	0.184	0.201	0.012~0.390	2.105	0.037

图2 因变量为FAI的标准化残差图

Fig.2 Standardized residual plot for the dependent variable FAI

表3 MB组FV影响因素的多元线性回归分析

Tab.3 Multiple linear regression analysis of factors influencing FV in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	268.063	-130.277~666.403	1.332	0.185
年龄	0.064	1.291	-1.692~4.274	0.856	0.393
性别	-0.026	-10.753	-73.864~52.358	-0.337	0.737
体质量指数	-0.061	-4.443	-15.851~6.966	-0.771	0.442
LAD-MB长度	-0.101	-2.845	-6.981~1.291	-1.361	0.176

表3 MB组FV影响因素的多元线性回归分析

Tab.3 Multiple linear regression analysis of factors influencing FV in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	268.063	-130.277~666.403	1.332	0.185
年龄	0.064	1.291	-1.692~4.274	0.856	0.393
性别	-0.026	-10.753	-73.864~52.358	-0.337	0.737
体质量指数	-0.061	-4.443	-15.851~6.966	-0.771	0.442
LAD-MB长度	-0.101	-2.845	-6.981~1.291	-1.361	0.176

图3 因变量为FV的标准化残差图

Fig.3 Standardized residual plot for the dependent variable FV

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