合并非酒精性脂肪肝的冠心病患者严重程度影响因素分析

An analysis of factors influencing severity of patients with coronary heart disease combined with nonalcoholic fatty liver disease

目的探讨合并非酒精性脂肪肝(NAFLD)的冠心病患者严重程度的影响因素。方法合并NAFLD冠心病患者201例分为单支病变组(112例)和多支病变组(89例)或狭窄组(101例)和闭塞组(100例),检测相关临床指标,采用多因素Logistic回归分析和ROC曲线分析,分析NAFLD的冠心病患者的危险因素。结果狭窄组和闭塞组的高血压和糖尿病患者比例以及TC、LDL和肝脏硬度差异均有统计学意义(P<0.05)。单支病变和多支病变的高血压和糖尿病患者比例以及TC、TG、LDL和肝脏硬度差异亦有统计学意义(P<0.05)。糖尿病、高血压、高LDL和肝脏硬度大是合并NAFLD的冠心病患者严重程度的危险因素(P<0.05)。合并NAFLD冠心病患者严重程度的ROC曲线下面积为0.841,肝脏硬度临界值为11.6kPa(P<0.05)。结论肝脏硬度是评估合并NAFLD冠心病患者严重程度的重要因素。

Objective To investigate the factors influencing the severity of coronary heart disease（CHD）patients with non-alcoholic fatty liver disease（NAFLD）.Methods A total of 201 CHD patients with NAFLD was divided into groups of A（single vessel lesion,112 cases）and B（multivessel lesions,89 cases）or groups of C（stenosis,101 cases）and D（occlusion,100 cases）.The relevant clinical indicators were detected.The risk factors related to the severity of CHD patients with NAFLD were analyzed by multivariate Logistic analysis and ROC curve.Results The percentages of patients with hypertension and diabetes,TC,LDL and liver hardness were significantly different between group C and group D（P〈0.05）.The percentages of patients with hypertension and diabetes,TC,TG,LDL and liver hardness were significantly different between group A and group B（P〈0.05）.Hypertension,diabetes,high LDL and liver hardness were the risk factors related to the severity of CHD patients with NAFLD（P〈0.05）.The area under ROC curve in evaluating the severity of CHD was 0.841 and the cut-off value of tiver hardness was 11.6 kPa（P〈0.05）.Conclusion Liver hardness is an important factor in evaluating the severity of CHD patients with NAFLD.