非酒精性脂肪性肝病与冠心病的相关性研究

Correlation between Nonalcoholic Fatty Liver Disease and Coronary Heart Disease

目的研究非酒精性脂肪性肝病(NAFLD)与冠心病(CHD)的相关性,阐明其作为冠心病预测因素的价值,为冠心病的预防和治疗提供资料和依据。方法随机选取疑诊"冠心病"住院的患者101例行冠状动脉造影和肝脏超声检查,确诊冠心病69例(冠心病组),其中合并NAFLD 44例(CHD-NAFLD组),单纯冠心病25例(单纯CHD组);非冠心病患者32例(非冠心病组),其中合并NAFLD 7例(单纯NAFLD组),未合并NAFLD者25例(对照组)。收集患者的基本临床资料并检测血生化指标。结果冠心病患者中NAFLD发生率明显高于非冠心病患者(63.77%和21.87%,P<0.01),合并NAFLD的冠心病患者以多支病变为主(P<0.05),且冠状动脉病变程度较重。Logistic回归分析显示,NAFLD可以独立地增加冠心病的发病风险〔P=0.001,OR=6.014,95%CI(2.104,17.192)〕。结论 NAFLD与冠心病存在明显的独立相关性,且与冠心病的严重程度相关,NAFLD是冠心病独立危险因素,可用其初步评估心血管事件发生的危险程度。

Objective To explore the possible relationship between nonalcoholic fatty liver disease（NAFLD） and coronary heart disease（CHD）.Methods A total of 101 randomly selected patients with suspected CHD underwent coronary angiography and abdominal ultrasonography.Among whom 69 cases were confirmed to be with CHD,including 44 cases complicated by NAFLD（CHD-NAFLD group） and 25 cases with simple CHD（simple CHD group）;32 cases were excluded the possibilities of CHD,among whom 7 cases were confirmed to be with NAFLD（simple NAFLD group） and another 25 cases without NAFLD fell into control group.The medical history was collected and blood biochemical analyses were performed.Results The prevalence of NAFLD in the CHD group was significantly higher than that in the non-CHD groups（63.77% vs.21.87%,P0.01）.Most patients in the CHD-NAFLD group had multi-vessel lesions in the coronary artery（P0.05）,and coronary artery lesions tended to be more severe.Logistic regression analysis indicated that NAFLD independently increased the risk of CHD（P=0.001,OR=6.014,95%CI（2.104,17.192））.Conclusion NAFLD is an independent predicator for CHD and is related to the severity of CHD.