Gensini评分与冠状动脉粥样硬化性心脏病合并非酒精性脂肪性肝病的相关性研究

Correlational research of Gensini score and coronary atherosclerotic disease complicated with nonalcoholic fatty liver disease

目的分析Gensini评分与冠状动脉粥样硬化性心脏病(CAD)患者合并非酒精性脂肪性肝病(NAFLD)的相关性。方法收集2018年1月—2021年12月期间梅州市人民医院收治的CAD患者340例,其中男性252例,女性88例,平均年龄(58.3±9.2)岁;将患者分为CAD合并NAFLD(NAFLD组)164例与单纯CAD(非NAFLD组)176例,比较两组资料,分析NAFLD组肝组织学特征Gensini评分结果。结果NAFLD组年龄为(57.4±9.6)岁,显著小于非NAFLD组患者[(59.0±9.1)岁,P<0.05];NAFLD组BMI为(27.2±3.1)kg/m^(2),显著高于非NAFLD组[(24.8±3.4)kg/m^(2),P<0.05];NAFLD组腰围为(96.5±9.1)cm,显著高于非NAFLD组[(84.6±9.5)cm,P<0.05];NALFD组HDL、TG为(0.9±0.2)mmol/L、(1.8±0.5)mmol/L,与非NAFLD组[(1.1±0.2)mmol/L、(1.6±0.4)mmol/L]比,差异具有统计学意义(P<0.05);此外,NAFLD组Gensini评分为(56.9±9.1)分,显著高于非NAFLD组[(48.2±8.2)分,P<0.05]。记录收集NAFLD组冠脉病变程度轻、中及重度分别为32例(19.5%)、21例(12.8%)及111例(67.7%),非NAFLD为55例(31.2%)、38例(21.6%)及83例(47.1%),差异具有统计学意义(P<0.05)。另外164例CAD合并NAFLD患者肝脂肪变程度S0级20例,S1级57例,S2级64例,S3级23例,各肝脂肪变程度Gensini评分分别为(10.5±1.3)分、(34.4±4.2)分、(65.9±8.0)分及(130.8±15.7)分,差异具有统计学意义(P<0.05)。结论不同肝脂肪变程度CAD合并NAFLD患者Gensini评分具有显著差异,Gensini评分有助于定量评价患者的肝脂肪变程度。

Objective To explore the relationship between nonalcoholic fatty liver disease(NAFLD)and Gensini score in patients with coronary atherosclerotic disease(CAD).Methods 340 CAD patients hospitalized from January 2018 to December 2021 were collected,including 252 males and 88 females in Meizhou People’s Hospital,with an average age of(58.3±9.2)years.340 CAD patients were divided into 164 cases of CAD combined with NAFLD(NAFLD group)and 176 cases of simple CAD(non-NAFLD group).The diagnosis of CAD and NAFLD met the requirements.The clinical data of NAFLD group and non-NAFLD group were compared,and the results of Gensini score of liver histological features in NAFLD group were analyzed.Results The age,body mass index(BMI)of NAFLD group were(57.4±9.6)years old,(24.8±3.4)kg/m^(2),which were significantly different with non-NAFLD group[(59.0±9.1)years old,(27.2±3.1)kg/m^(2),P<0.05].The waist circumference of NAFLD group was(96.5±9.1)cm,which was significantly higher than that of non-NAFLD group[(84.6±9.5)cm,P<0.05].High-density lipoprotein(HDL)and triglyceride(TG)in NALFD group were(0.9±0.2)mmol/l and(1.8±0.5)mmol/l,which were significantly different from those in non-NAFLD group[(1.1±0.2)mmol/l and(1.6±0.4)mmol/l](P<0.05).In addition,Gensini score of NAFLD group was(56.9±9.1)points,significantly higher than that of non-NAFLD group[(48.2±8.2)points,P<0.05].The mild,moderate and severe degree of coronary artery lesions in NAFLD group were 32 cases(19.5%),21 cases(12.8%)and 111 cases(67.7%),while those in non-NAFLD group were 55 cases(31.2%),38 cases(21.6%)and 83 cases(47.1%),the difference was statistically significant.In 64 CAD patients with NAFLD,the degree of hepatic steatosis was 20 cases in S0 grade,57 cases in S1 grade,64 cases in S2 grade and 23 cases in S3 grade.Gensini scores of each degree of hepatic steatosis were(10.5±1.3)points,(34.4±4.2)points,(65.9±8.0)points and(130.8±15.7)points,respectively.Conclusion Gensini scores of patients with CAD and NAFLD of different degrees of liver steatosis are significantly different,and Gensini scores are helpful to quantitatively evaluate the degree of liver steatosis of patients.