| Part ?:Objective Using ultrasound to observe the changes of EAT and pre-hepatic fat thickness in60-89 years old patients,and evaluate their correlation with dyslipidemia.Materials and Methods The part collected 148 patients.According to the lipid levels of the patients,the patients were divided into dyslipidemia group and control group,85 cases in dyslipidemia group and 63 cases in control group.Compared the pre-hepatic fat and EAT thickness between the two groups.To determine the correlation between pre-hepatic fat,EAT and dyslipidemia,and the predictive value of EAT thickness and hepatic fat on dyslipidemia,and the optimal cut-off value for prediction.Results1.There was no significant difference in gender and age between dyslipidemia group and control group(p>0.05);2.Using t-test to compare EAT thickness and pre-hepatic fat thickness between the dyslipidemia group and the control group.The EAT fat thickness in the dyslipidemia group were significantly thicker than those in the control group(p<0.05).3.According to Pearson's correlation analysis,it was concluded that there was a correlation between the right ventricular anterior wall EAT and apical EAT thickness,the right ventricular anterior wall EAT and pre-hepatic fat thickness,apical EAT thickness EAT and pre-hepatic fat thickness(r=0.53,0.25,0.29,p<0.05);4.Using Spearman's correlation analysis,we found that there was a correlation between EAT thickness and dyslipidemia both in right ventricle anterior wall and apical(r= 0.19,0.20,p<0.05),and there was no significant correlation between pre-hepatic fat thickness and dyslipidemia.(p>0.05),5.Using echocardiographic measurement EAT thickness in the right ventricular anterior wall suggested that the area under the ROC curve for elevated dyslipidemia in aged 60-89 years was 0.61(p<0.05),the diagnostic cut-point value was 12.31 mm,and the sensitivity was 55.3%,the specificity was 69.8%.The area under the ROC curve for apical EAT thickness was 0.61 too(p<0.05),the diagnostic cut-point value was 7.37 mm,the sensitivity was 76.5%,and the specificity was 52.4%.Conclusion1.The thickness of EAT in aged 60-89 years was related to pre-hepatic fat thickness and dyslipidemia.There was no significant correlation between pre-hepatic fat thickness and dyslipidemia.2.When the right ventricle anterior wall EAT thickness is greater than 12.31 mm in the elderly aged 60-89 years and/or the apical EAT thickness greater than 7.37 mm,EAT is more associated with dyslipidemia.Part ?:Objective Using Echocardiography and high-frequency ultrasound to observe EAT thickness and carotid atherosclerosis plaque stability,to evaluate whether there is a correlation between EAT and carotid plaque stability.Materials and Methods The study is collecting 174 cases of young elderly patients.The patients were divided into young elderly group and elderly group according to the age.Using high frequency ultrasound evaluate carotid artery plaque stability,each groups were divided into stable carotid atherosclerotic plaque group and unstable carotid atherosclerotic plaque group.There were 98 cases in elderly group,of which 40 were in stable group and 58 in unstable group.There were 76 cases in elderly group,of which 26 cases in stable group and 50 cases in unstable group.Compared with the right ventricle anterior wall EAT thickness?apical EAT thickness and pre-hepatic fat thickness,determined the best cut-off value.Results1.There was no significant difference in the incidence of plaque stability between the young elderly group and elderly group.In the unstable plaque group,the plaques were more common in multiple types,and the instability of single plaque was mainly of simple type;2.The t-test and ?2 test were used to compare the thickness of EAT,the gender,age and blood lipid levels between the young elderly group and elderly group.The difference was not statistically significant.3.The t-test and ?2 test were used to compare the gender,age and blood lipid levels between the stable group and the unstable group.The difference was not statistically significant.4.The thickness of apical EAT and the thickness of EAT in the right ventricle anterior wall of the unstable plaque group were significantly thicker than those in the stable plaque group both in the young elderly group and elderly group(p<0.05),and plaque stability was negatively correlated with EAT thickness,r =-0.38,-0.30 in the young elderly group,r =-0.39,-0.32 in the elderly group;5.The right ventricle anterior wall EAT thickness was highly correlated with the thickness of apical EAT both in the young elderly group and elderly group(r = 0.47?0.40,p<0.01).6.According to correlation analysis,in the young elderly group there was no significant correlation between apical EAT thickness and TG,TC,HDL-C,LDL-C(p>0.05),but the thickness of EAT in the anterior wall of right ventricle was negatively correlated with HDL-C(r=-0.21p<0.05);In the elderly group there was no significant correlation between EAT thickness and TG,TC,HDL-C,LDL-C(p> 0.05)7.The area under the ROC curve of the right ventricle anterior wall and the apical EAT thickness prompted the plaque stability were 0.74?0.68,and the cutoff values were11.00 mm and 7.35 mm,the diagnostic sensitivity were 82.8% and 84.5% respectively,and the specificity were 62.5% and 50.0%;The area under the ROC curve of the right ventricle anterior wall and the apical EAT thickness prompted the plaque stability were0.74 ? 0.70,and the cutoff values were 10.68 mm and 10.60 mm,the diagnostic sensitivity were 82.0% and 36.0% respectively,and the specificity were 57.7% and100.0%;Conclusion1.Epicardial adipose tissue thickness and carotid atherosclerotic plaque stability have negative correlation in young elderly and elderly patients.2.In young elderly population,the relationship of EAT and carotid atherosclerotic plaque instability is higher when the EAT thickness is greater than 11.00 mm in the anterior wall of the right ventricle or(and)the EAT thickness is greater than 7.35 mm at the apical.In elderly population,the risk of carotid atherosclerotic plaque instability is higher when the EAT thickness is greater than 10.68 mm in the anterior wall of the right ventricle or(and)the EAT thickness is greater than 10.60 mm at the apical.Part ?:Objective This part used echocardiography to observe the changes of EAT thickness,evaluate whether there is a correlation between EAT and the occurrence of stork.Materials and Methods This part collected a total of 194 young elderly patients in our hospital.The patients were divided into young elderly group and elderly group according to the age.According to CT and MRI results,the patients were divided into non-lacunar infarction(NLI)group,lacunar infarction(LI)group and control group.Compared EAT thickness and general parameters to determine the value of EAT prediction of ischemic stroke and to determine the best prediction of the cut-off value.Results1.There was no significant difference in general parameters such as sex,age,TG,TC,HDL-C,LDL-C,lipoprotein(a)and HCY between NLI group and LI group as compared with the control group;2.Using ANOVA to compare NLI group,LI group and control group in young elderly group,EAT thickness of right ventricular anterior wall in each group was statistically significant difference(p<0.05);apical EAT thickness in each group was no significant difference(p>0.05);3.Compared with LI group,NLI group and control group by LSD-T test,the EAT of NLI group was significantly thicker than LI group and control group(p<0.05),while there was no significant difference between LI group and control group(p>0.05).4.According to ?2 test,the incidence of unstable plaque in NLI group was higher than that in LI group and control group,and there was a statistical difference(p<0.05),but there was no significant difference in the incidence of LI group and control group.But there was no significant difference in elderly group.5.Spearman correlation analysis showed that in young elderly group the thickness of EAT in the anterior wall of right ventricle was positively correlated with cerebral infarction(p<0.05),TG,TC,HDL-C,LDL-C,lipoprotein(a),HCY and apical EAT thickness had no correlation with cerebral infarction(p>0.05);6.The area under the ROC curve of the right ventricle anterior wall EAT in young elderly group,measured by echocardiographic prompted the NLI was 0.69 and the cutoff value was 11.54 mm,the diagnostic sensitivity was 63.94% and the specificity was 76.32%.7.In young elderly group that NLI group and control group right ventricular anterior wall EAT thickening rate comparison,according to the study to determine the value of the diagnostic cut-off point to determine right ventricular anterior wall EAT thickening,compared the two groups of thickening rate was statistically significant difference(p<0.05).Conclusion1.The changes of EAT thickness of the right ventricular anterior wall and the carotid instability plaques in the younger elderly group are related to the occurrence of NLI in young elderly group.2.The observation of EAT thickness in young elderly patients had a certain early warning effect on the occurrence of cerebral infarction.When the EAT thickness of right anterior wall was greater than 11.54 mm,the relationship on NLI increase. |
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