摘要
目的分析非酒精性脂肪性肝病(NAFLD)合并冠心病(CHD)患者冠脉病变程度及其危险因素。方法2015年1月~2017年1月我院收治的154例NAFLD患者,经冠脉造影诊断CHD 71例。使用超声和CT检查诊断脂肪肝程度,应用Gensini评分评判冠脉病变程度。采用Logistic多因素回归分析影响冠脉病变的因素。结果 71例CHD与83例非CHD患者在合并糖尿病、吸烟及FPG、TC、TG、ALT、AST、GGT、hs-CRP和HOMA-IR水平方面比较有显著性差异(t/x2=7.62、5.38、3.82、5.80、3.72、8.79、3.10、5.75、5.25、5.93,P<0.05或P<0.01);多因素Logistic回归分析显示,合并糖尿病、FPG、TC、ALT、hs-CRP、HOMA-IR是NAFLD合并CHD的独立危险因素(P<0.05或P<0.01);37例轻度、23例中度和11例重度NAFLD合并CHD患者单支、双支和三支冠状病变比例比较有显著性差异(x2=14.8,P<0.01)。结论 NAFLD合并CHD发病率较高,及时了解其发生的独立危险因素,做好重点监测和防治是减少CHD发生的积极措施。
Objective To analyze the severity of coronary artery lesions and risk factors in patients with nonalcoholic fatty liver disease（NAFLD） complicated by coronary heart disease（CHD）.Methods 154 patients with NAFLD were recruited in our hospital between January 2015 and January 2017,and 71 were found with CHD by coronary angiogram.The degree of fatty liver was determined by altrasonography and/or CT scan.Logistic analysis was applied to screen the risk factors for CHD occurrence.Results There were statistically significant differences between the two groups as respect to the percentages of diabetes and smoking,and serum levels of FPG,TC,TG,ALT,AST,GGT,hs-CRP and HOMA-IR（t/x～2=7.62,5.38,3.82,5.80,3.72,8.79,3.10,5.75,5.25,5.93,P 〈0.05 or P〈 0.01）;multivariate Logistic regression analysis showed that diabetes,FPG,TC,ALT,hs-CRP and HOMA-IR were the independent risk factors of CHD in patients with NAFLD（P 〈0.05 or P 〈0.01）;among 71 patients with CHD,there were 37 cases with mild,23 with moderate and 11 with severe NAFLD,and there were statistically significant differences among the three groups as to the percentages of single,double and three branches coronary artery lesions（x2=14.8,P〈0.01）.Conclusion The incidence of CHD in patients with NAFLD is relatively higher,and clinicians must take the risk factors into consideration in clinical practice in order to decrease the morbidity and mortality of heart diseases.
作者
严晨丽
王晶晶
王军
Yan Chenli;Wang Jingjing;Wang Jun(Department of Hepatobiliary and Pancreatic Surgery,Central Hospital,Affiliated to Huazhong University of Science and Technology,Wuhan 430000,Hebei Province,China)
出处
《实用肝脏病杂志》
CAS
2018年第5期737-740,共4页
Journal of Practical Hepatology
基金
湖北省教育厅重点科研项目(编号:D20142102)
关键词
非酒精性脂肪性肝病
冠心病
危险因素
冠脉病变程度
Nonalcoholic fatty liver disease
Coronary heart disease
Risk factors
Severity of coronary artery lesions
