冠心病合并2型糖尿病患者非酒精性脂肪性肝病发病率及危险因素研究

Prevalence and Risk Factors of Non-alcoholic Fatty Liver Disease in Coronary Heart Disease with Type 2 Diabetes Mellitus Patients

目的探讨冠心病合并2型糖尿病患者非酒精性脂肪性肝病(NAFLD)的发病率和危险因素。方法对280例冠状动脉造影诊断为冠心病的2型糖尿病患者入院期间均行空腹肝胆超声检查以确诊NAFLD,分析NAFLD的危险因素。结果本组NAFLD的发病率为63.6%(178/280)。NAFLD的发生率随着冠状动脉病变程度加重而增加(χ2趋势=6.148,P=0.01)。中重度NAFLD患者的多支病变发生率明显多于轻度者,差异有统计学意义(χ2=10.317,P<0.01)。多因素Logistic回归分析显示,冠心病多支病变和左主干病变是NAFLD的独立危险因素。结论冠心病合并2型糖尿病患者NAFLD发病率较高,冠状动脉多支病变、左主干病变是其发生NAFLD的重要危险因素。

Objective To investigate the incidence and risk factors of NAFLD in coronary artery disease with type 2 diabetes mellitus patients undergoing coronary angiogram. Methods 280 patients with eoronary artery disease in type 2 diabetes mellitus who underwent coronary angiogram were enrolled into this study. All patients had ultrasound screening for fatty liver. Results Among 280 recruited patients, 178 （63.6%） had fatty liver by ultrasonography. The incidence of NAFLD increased with the severity of eoronary artery lesions（χ2trend = 6. 148 , P =0. 01 ）. Multi - vessel lesions in moderate to severe NAFLD was higher than the mild level （ χ2 = 10. 317, P 〈 0.01 ）. By muhivariable Logistie regression analysis, multi - vessel lesions or stenosis of left main stem were risk factor in NAFLD patients with coronary heart disease in diabetes mellitus. Conclusion In eoro- nary artery disease patients with diabetes mellitus, multi - vessel lesions and stenosis of left main stem are the important risk factors for NAFLD occurrence.