非酒精性脂肪性肝病与冠心病患病率和严重程度以及预后的相关性  

Associations of Non-alcoholic Fatty Liver Disease with Prevalence, Severity,and Prognosis of Coronary Heart Disease

作　　者：李晨怡[1] 陈佳[1] 施向凡[1] LI Chenyi;CHEN Jia;SHI Xiangfan(Department of Medical Care for Cadres,Zhejiang Hospital,Hangzhou 310012,China)

机构地区：[1]浙江医院干部保健科

出　　处：《中国医学科学院学报》2019年第2期156-161,共6页Acta Academiae Medicinae Sinicae

基　　金：浙江省医药卫生科技项目(2013KYB006)~~

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)与冠心病(CHD)的患病率、病变严重程度和预后的相关性。方法 选择2013年6月至2015年6在本院接受冠脉造影检查的患者512例,B超判断脂肪肝、根据冠脉造影结果计算Gensini积分,分析CHD的独立预测因素,并对其中276例CHD患者进行随访研究,分析NAFLD与心血管终点事件的相关性。结果 NAFLD组和非NAFLD组的CHD患病率分别为76.8%、50.7%(P=0.000),靶血管数分别为2(1,3)、1(1,3)(P=0.019),Gensini积分分别为29.02±27.62、24.04±20.18(P=0.022),差异均有统计学意义。NAFLD为CHD的独立预测因素(OR=2.28,95%CI=1.54~3.56,P<0.001)。NAFLD和非NAFLD患者的心血管终点事件风险的差异无统计学意义(P>0.1)。Cox回归分析显示,NAFLD不是CHD患者心血管终点事件发生的预测因素(HR=0.95,95%CI=0.62~1.58,P=0.691)。结论 NAFLD为CHD的独立预测因素,并与冠脉狭窄程度相关,但NAFLD不能预测CHD患者的预后。Objective To explore the associations of non-alcoholic fatty liver disease(NAFLD)with the prevalence,severity,and prognosis of coronary heart disease(CHD). Methods A total of 512 hospitalized patients undergoing coronary angiography in our department from June 2013 to June 2015 were enrolled.Fatty liver was judged by ultrasound screening,and Gensini score was calculated according to the result of coronary angiography .Then the independent predictors of CHD were analyzed.The association between NAFLD and cardiovascular endpoints was analyzed during prospective follow-up among 276 CHD patients. Results The CHD prevalence was 76.8% in NAFLD group and 50.7% in non-NAFLD group( P =0.000),the number of target vessels was 2(1,3)and 1(1,3)( P =0.019),and the Gensini score was(29.02±27.62)and(24.04±20.18)( P =0.022),respectively.NAFLD was an independent predictor of CHD( OR =2.28,95% CI =1.54-3.56, P <0.001 ).The risk of cardiovascular endpoints was not significantly different between NAFLD group and non-NAFLD group( P >0.1).Cox regression analysis showed that NAFLD was not a predictor of cardiovascular endpoints in patients with CHD( HR =0.95,95% CI =0.62-1.58, P =0.691). Conclusions NAFLD is an independent predictor of CHD,and it is related to severity of coronary artery stenosis.However,it can not predict the clinical outcomes of patients with CHD.

关 键 词：非酒精性脂肪性肝病 冠心病 GENSINI积分 预后 

分 类 号：R575.5[医药卫生—消化系统]