脂肪肝与腔隙性脑梗死的关系分析

Association between fatty liver disease and lacunar infarction

目的探讨脂肪肝是否腔隙性脑梗死的危险因素。方法回顾性分析2007年-2017年在宁德市医院住院的457例腔隙性脑梗死患者(腔隙性脑梗死组)以及同期住院的120例对照患者(对照组)的临床资料,分析脂肪肝是否为腔隙性脑梗死发生的危险因素。计数资料2组间比较采用χ2检验,计量资料2组间比较用t检验。腔隙性脑梗死的危险因素筛选采用单因素及多因素回归分析。结果腔隙性脑梗死组患者脂肪肝所占比例高于对照组(60. 39%vs 39. 17%,χ2=17. 379,P <0. 001)。多因素回归分析结果显示,校正了年龄、性别、吸烟、饮酒、高血压及糖尿病后,脂肪肝是腔隙性脑梗死的独立危险因素[比值比(OR)=1. 96,95%可信区间(95%CI):1. 21～3. 02,P=0. 003]。但肥胖与脂肪肝具有明显的相互作用(P=0. 001)。进一步回归分析结果显示,在非肥胖亚组,脂肪肝是腔隙性脑梗死的独立危险因素(OR=3. 29,95%CI:1. 55～7. 23,P <0. 001);在肥胖亚组脂肪肝不是腔隙性脑梗死的独立危险因素(P=0. 532),年龄(OR=6. 67,95%CI:1. 98～21. 56,P <0. 001)、高血压(OR=6. 38,95%CI:5. 12～12. 06,P <0. 001)是腔隙性脑梗死的独立危险因素。结论非肥胖性脂肪肝是腔隙性脑梗死的独立危险因素。

Objective To investigate whether fatty liver disease is a risk factor for lacunar infarction.Methods A retrospective analysis was performed for the clinical data of 457 patients with lacunar infarction(lacunar infarction group)and 120 control patients,who were hospitalized in our hospital from 2007 to 2017,to analyze whether fatty liver disease is a risk factor for lacunar infarction.The chi-square test was used for comparison of categorical data between groups,and the t-test was used for comparison of continuous data between groups.Univariate and multivariate regression analyses were used to screen out the risk factors for lacunar infarction.Results The lacunar infarction group had a significantly higher incidence rate of fatty liver disease than the control group(60.39%vs 39.17%,χ2=17.379,P<0.001).The multivariate regression analysis showed that after adjustment for age,sex,smoking,drinking,hypertension,and diabetes,fatty liver disease was an independent risk factor for lacunar infarction(odds ratio[OR]=1.96,95%confidence interval[CI]:1.21-3.02,P=0.003).There was a significant interaction between obesity and fatty liver disease(P=0.001).Non-obese fatty liver disease was an independent risk factor for lacunar infarction(OR=3.29,95%CI:1.55-7.23,P<0.001);however,in the obese subgroup,obese fatty liver disease was not an independent risk factor for lacunar infarction(P=0.532),Age(OR=6.67,95%CI:1.98~121.56,P<0.001),hypertension(OR=6.38,95%CI:5.12~12.06,P<0.001)were independent risk factors for lacunar infarction.Conclusion Non-obese fatty liver disease is an independent risk factor for lacunar infarction.