摘要
目的探讨老年非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者纤维化评分(NAFLD Fibrosis Score,NFS)与颈动脉不稳定斑块的相关性。方法回顾性分析191例60岁及以上NAFLD患者的临床资料和颈动脉斑块情况,NFS评分以0.676为界值,肝纤维化组(NFS,肝纤维化组)65例、非肝纤维化组(NFS<0.676)126例。按照NFS四分位数将患者分为Q1(NFS<-0.865分)48例、Q2(-0.865分≤NFS<0.100分)48例、Q3(0.100分≤NFS<1.070分)47例、Q4(NFS≥1.070分)48例,分析NFS评分与颈动脉斑块性质的相关性。结果趋势检验结果提示,随NFS评分升高,颈动脉不稳定斑块的检出率增加(F=8.573,P=0.004)。肝纤维化组颈动脉不稳定斑块检出率高于非肝纤维化组,78.5%(51例)比60.3%(76例),差异有统计学意义(χ^2=5.883,P=0.015)。多因素Logistic分析结果显示,调整年龄、性别、糖尿病、高血压和血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等混杂因素后,肝脏纤维化(NFS≥0.676分)仍与颈动脉不稳定斑块独立相关(β=0.816,95%CI:1.110~4.607,OR=2.261,P=0.025)。结论老年NAFLD患者NFS得分与颈动脉不稳定斑块相关,NFS得分偏高是颈动脉不稳定斑块的独立危险因素,对NFS评分≥0.696分的患者,应注意评估颈动脉不稳定斑块情况。
Objective To investigate the correlation between nonalcoholic fatty liver disease(NAFLD)fibrosis score(NFS)and unstable plaques of carotid in elderly NAFLD patients.Methods The clinical and carotid plaques data of 191 elderly(≥60 years old)admitted into our department between July 2016 and January 2018 were retrospectively collected.With NFS 0.676 as a cut-off point,the patients were divided into a liver fibrosis group(NFS≥0.676,n=65)and a non-liver fibrosis group(NFS<0.676,n=126).Based on quartiles of NFS,the patients were divided into four groups:the Q1 group(NFS<-0.865,n=48),the Q2 group(-0.865≤NFS<0.100,n=48),the Q3 group(0.1≤NFS<1.070,n=47),the Q4 group(NFS≥1.070,n=48).The correlation of NFS with the property of carotid plaques was analyzed.Results The detection rate of unstable carotid plaques was increased along with the increase of NFS(F=8.573,P=0.004).The detection rate of unstable carotid plaques was higher in the liver fibrosis group than in the non-liver fibrosis group(78.5%or 51/65 vs.60.3%or 76/126,χ^2=5.883,P=0.015).Multiple logistic regression analysis showed that liver fibrosis(NFS≥0.676)was independently correlated with unstable carotid plaques(β=0.816,95%CI:1.110~4.607,OR=2.261,P=0.025)after adjusting for possible confounding factors including age,gender,diabetes mellitus,hypertension,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein.Conclusions NFS is correlated with unstable carotid plaques in elderly NAFLD patients,and the higher NFS is the independent risk factor for unstable carotid plaques for elderly NAFLD patients with NFS higher than 0.676.We should pay more attention to the evaluation of unstable carotid plaques.
作者
魏雅楠
邓利华
王晶桐
Wei Yanan;Deng Lihua;Wang Jingtong(Department of Geriatrics,Peking University People's Hospital,Beijing 100044,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2019年第11期1251-1253,共3页
Chinese Journal of Geriatrics
关键词
脂肪肝
肝纤维化
颈动脉
Fatty liver
Liver cirrhosis
Carotid arteries
