非酒精性脂肪性肝病患者发生冠状动脉疾病的危险因素分析  

Risk factors of coronary artery disease in patients with nonalcoholic fatty liver disease

作　　者：王春亚[1] 柳伟伟[2] 赵攀[3] 

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,北京100029 [2]解放军军事医学科学院卫生统计学教研室,北京100850 [3]解放军第302医院临床试验中心,北京100039

出　　处：《疑难病杂志》2017年第7期657-659,664,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81501652)

摘　　要：目的分析非酒精性脂肪性肝病患者发生冠状动脉疾病的危险因素。方法回顾性分析2007年1月-2013年12月在首都医科大学附属北京安贞医院和解放军第302医院住院确诊为非酒精性脂肪性肝病且资料齐全的患者1 525例,按有无合并冠状动脉疾病(CAD)分为CAD组和非CAD组,比较2组临床资料,并进行冠状动脉疾病发病风险分析。结果确诊非酒精性脂肪性肝病1 525例,其中发生冠状动脉疾病171例(11.2%),男91例,女80例。多因素Logistic回归分析显示,非酒精性脂肪性肝病患者发生冠状动脉疾病的危险因素为:年龄(OR=1.020,95%CI 1.007~1.034,P<0.01)、心血管病家族史(OR=2.023、95%CI1.415~2.892,P<0.01)和糖尿病(OR=2.475、95%CI 1.782~3.437,P<0.01)。结论对于临床上具有高龄、心血管病家族史和糖尿病危险因素的非酒精性脂肪性肝病患者,应进行心血管专科的干预和随访。Objective To evaluate the incident risk of coronary artery disease（CAD） in patients with nonalcoholic fatty liver disease（NAFLD）.Methods From January 2007 to December 2013,1 525 patients diagnosed nonalcoholic fatty liver disease in Beijing Anzhen Hospital and PLA 302 Hospital were retrospectively included in the case screening,they were divided into patients with CAD（CAD group）and patients without CAD（non-CAD group）,the clinical datas were compared between 2 group,coronary artery disease risk factors were analysed.Results Finally,171 NAFLD patients（11.2%） with incident CAD were included in the analysis.Among these patients,91 were male and 80 were female.The multivariate analysis showed that age（OR =1.020,95%C/1.007-1.034,P 0.01）,family history of cardiovascular diseases（OR =2.023,95%CI 1.415-2.892 P 0.01;） and diabetes（OR =2.475,95%C/1.782-3.437 P 0.01;） were eventually selected by the logistic regression.Conclusion Age,diabetes and family history of cardiovascular diseases were associated with the development of CAD in patients with NAFLD.For the patients who were identified with these risk factors,further clinical assessment or medical interventions should be performed.

关 键 词：冠状动脉疾病 危险因素 非酒精性脂肪性肝病 

分 类 号：R575.5[医药卫生—消化系统]