目的探讨低剂量平扫64层螺旋 CT评价心肌梗塞患者的心外膜脂肪组织价 值。方法 2011年7月到2014年8月选择在 我院诊治的心肌梗塞患者90例，都使用低 剂量平扫64层螺旋CT判定阻塞性粥样硬化 情况，同时进行心外膜脂肪厚度的测定 与临床一般资料的记录。结果 90例心肌 梗塞患者判断为无阻塞粥样硬化60例，阻 塞性粥样硬化30例，两组的性别、年龄、 体重指数、TG、TC、LDL、HDL与空腹血糖 值对比差异都无统计学意义(P>0.05)。无 阻塞粥样硬化患者的心外膜脂肪厚度为 5.67±1.23mm，而阻塞性粥样硬化患者为 9.24±1.46mm，阻塞性粥样硬化患者的心 外膜脂肪厚度明显高于无阻塞粥样硬化患 者(P<0.05)。Logistic回归分析显示心外 膜脂肪厚度是导致阻塞粥样硬化的独立危 险因素，呈正相关(P<0.05)。Pearson相 关分析结果显示心外膜脂肪厚度与年龄、 空腹血糖、TG呈正相关；与HDL-C呈负相 关(P<0.05)。结论 低剂量平扫64层螺旋 CT评价能有效评价心肌梗塞患者的心外膜 脂肪组织厚度与阻塞粥样硬化情况，心外 膜脂肪组织是心肌梗塞阻塞粥样硬化的一 个重要危险因素，同时也受临床许多因素 影响。

Objective To investigate the values of Low-dose unenhanced 64-slice CT for the epicardial adipose tissue in the myocardial infarction patients. Methods From July 2011 to August 2014 ,90 myocardial infarction patients in our hospital were examined by low-dose unenhanced 64-slice CT to assess obstructive atherosclerosis, while measured epicardial fat thickness general information and kept the clinical records. Results 60 patients of the non-blocking atherosclerosis, 30 patients of obstructive atherosclerotic were finally confirmed in 90 patients with myocardial infarction, the gender, age, BMI, TG, TC, LDL, HDL and fasting blood glucose of the two were no differences in contrast statistically significant (P>0.05). Blocking atherosclerosis in patients with epicardial fat thickness were 5.67 ± 1.23mm, while obstructive atherosclerotic patients were 9.24 ± 1.46mm, epicardial fat thickness obstructive atherosclerosis in patients with atherosclerosis was significantly higher than that of non-blocking sclerosis patients (P<0.05). Logistic regression analysis showed that epicardial fat thickness was the independent risk factor for atherosclerosis obstruction and was positively correlated (P<0.05). Pearson correlation analysis showed that epicardial fat thickness and age, fasting blood glucose, TG was positively correlated; and HDL-C was negatively correlated (P<0.05). Conclusion Lowdose unenhanced 64-slice spiral CT evaluation can effectively evaluate the thickness of the myocardial infarction patients with obstructive epicardial adipose tissue atherosclerosis. Epicardial adipose tissue is an important risk factor for obstructive atherosclerosis of myocardial infarction, which is also affected by a number of clinical factors.