非酒精性脂肪性肝病与心血管疾病的相关性分析  

Cardiovascular disease in patients with non-alcoholic fatty liver disease

作　　者：王军[1] 魏艳玲[1] 范丽玲[1] 肖潇[1] 颜綦先[1] 李娅[1] 陈东风[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所消化内科,重庆市400038

出　　处：《实用肝脏病杂志》2013年第6期499-501,共3页Journal of Practical Hepatology

基　　金：国家自然科学基金青年科学基金项目(81200297);国家自然科学基金项目(81170382)

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)与心血管疾病(CVD)的关系。方法根据CT检查结果将研究对象分为NAFLD患者(48例)和健康人(43例),超声测定外周血管硬化和颈动脉内膜中层厚度(IMT)等相关指标,检测生化和内皮舒张功能指标,心脏CTA检测冠状动脉粥样病变。结果 NAFLD患者可溶性细胞间黏附分子-1[sICM-1,(185.1±36.2)ng/ml]、血内皮素-1[ET-1,(104.8±19.3)pg/ml]和臂踝脉搏波速度[baPWV,(15.5±2.3)cm/s]显著高于健康人(85.4±17.3)ng/ml、(67.5±12.1)pg/ml和(13.6±2.4)cm/s,(P<0.05),而肱动脉血流介导的内皮依赖性舒张功能[FMD,(8.1±2.4)%]明显低于健康人(13.2±3.5)%,(P<0.05);此外,NAFLD患者颈动脉IMT厚度(1.31±0.35)mm、劲动脉(31.3%)和冠状动脉粥样斑块检出率(35.4%)均明显高于对照组(0.76±0.18)mm、9.3%和11.6%,(P<0.05);Pearson相关分析显示NAFLD分别与IMT、劲动脉和冠状动脉粥样斑块检出率显著正相关(P<0.01)。结论 NAFLD与CVD密切相关,NAFLD患者可能存在血管内皮功能障碍,应定期进行IMT和粥样斑块检测。Objective To investigate the risk factors of cardiovascular disease in patients with nonalcoholic fatty liver disease （NAFLD）. Methods Forty-eight patients with NAFLD and forty-three healthy persons were in-cluded in this study. The NAFLD was diagnosed by computed tomography. Ultrasound was taken for intimal medi-al thickness （IMT）and carotid atherosclerotic plaque examination. The clinical and biochemical features,endothelial function and coronary atherosclerotic plaque examination were also analyzed. Results The levels of sICM-1,ET-1 and baPWV in NAFLD group（185.1±36.2）ng/ml,（104.8±19.3）pg/ml and（15.5±2.3）cm/s were higher than those （85.4±17.3）ng/ml,（67.5±12.1）pg/ml and （13.6±2.4）cm/s,（P〈0.05）,while the FMD level （8.1±2.4）%was lower than that （13.2±3.5%）,（P〈0.05）in the healthy persons;In addition,the IMT （1.31±0.35）mmand the prevalence of patches in carotid（31.3%）and in coronary artery（35.4%）in patients with NAFLD increased than in healthy per-sons （0.76±0.18）mm,9.3% and 11.6%,（P〈0.05）. Conclusion NAFLD is closely associated with cardiovascular disease. The patients with NAFLD might have vascular endothelial dysfunction,and they might be checked-up for early evaluation of vascular atherosclerosis.

关 键 词：非酒精性脂肪性肝病 心血管疾病 内皮功能 粥样硬化 

分 类 号：R575.5[医药卫生—消化系统]