心肌梗死患者非酒精性脂肪性肝病的发生率及危险因素分析

Incidence and Risk Factors of Myocardial Infarction Complicated by Non-Alcoholic Fatty Liver Disease

目的探讨心肌梗死患者非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的发病率和危险因素。方法对北京安贞医院634例诊断为心肌梗死的患者在入院期间行空腹肝胆超声检查,并分为NAFLD组和非NAFLD组,统计分析两组发病率和危险因素。结果心肌梗死患者NAFLD发生率为52.2%(331/634)。NAFLD组体重指数、血清丙氨酸转氨酶高于非NAFLD组,两组差异有统计学意义(P<0.05)。NAFLD的发生率随着冠脉病变程度加重而增加(χ2=7.275,P=0.03)。多因素logistic回归结果显示,体重指数和冠心病多支病变、左主干病变是NAFLD的独立危险因素。结论心肌梗死患者,尤其是体重超重、多支病变、左主干病变的患者NAFLD的发生率高。

Objective To investigate the incidence and risk factors of non-alcoholic fatty liver disease （NAFLD） in patients with myocardial infarction. Methods A total of 634 patients with myocardial infarction from Beijing Anz- hen Hospital were asked to take liver and gallbladder ultrasonography during hospitalization, and then divided into the NAFLD and non-NAFLD groups. The incidence and risk factors of the two groups were then analyzed. Results The in- cidence of NAFLD was 52.2% （331/634）. Both body mass index （BMI） and serum alanine aminotransferase of the NAFLD group were higher than those of non-NAFLD group, with significant difference （P〈0.05）. The incidence of NAFLD was positively increased following the severity of coronary diseases 0（2=7.275, P=0.03）. The result of multivariable logistic regression analysis showed BMI, multi-vessel lesions of coronary disease, and left main coronary artery lesion were the independent risk factors of NAFLD. Conclusion The myocardial infarction patients who are particularly complicated by overweight, multi-vessel lesions and left main coronary artery lesion have a higher incidence of NAFLD.