轻度非酒精性脂肪肝血管内皮功能改变与颈动脉内中膜厚度的相关性  

Correlation betwen changes in cardiovascular endothelial function and carotid artery intima-media thickness in patients with mild nonalcoholic fatty liver disease

作　　者：范存芳[1] 刘振东[2] 王娟[3] FAN Cunfang;LIU Zhendong;WANG Juan(Special laboratory Department Shandong Rongjun General Hospital,Jinan 250013,P.R.China;Institute of Basic Medicine,Shandong Academy of Medical Sciences,Jinan 250002,P.R.China;The Second Hospital of Shandong University,Jinan 250033,P.R.China)

机构地区：[1]山东省荣军总医院特检科,山东济南250013 [2]山东省医学科学院基础医学研究所,山东济南250002 [3]山东大学第二医院,山东济南250033

出　　处：《医学影像学杂志》2019年第5期786-789,共4页Journal of Medical Imaging

基　　金：山东省民政厅科研基金项目(编号:20161002)

摘　　要：目的探讨轻度非酒精性脂肪肝(NAFLD)患者血管内皮功能的改变及其与动脉粥样硬化的关系。方法选择健康体检的130例轻度NAFLD患者(NAFLD组)及120例健康者(对照组)进行肱动脉内皮舒张功能和颈动脉超声检测。结果NAFLD组肱动脉内皮依赖性舒张功能(FMD)及非内皮依赖性舒张功能(NMD)分别为(11.92±3.28)%及(17.64±2.28)%,显著低于对照组〔分别为(15.34±3.00)%及(22.38±2.34)%,P均<0.001)。NAFLD组颈动脉内膜中层厚度(IMT)及斑块发生率显著高于对照组〔分别为(0.88±0.18)mmvs.(0.97±0.17)mm,P<0.001和36.9%vs.20.0%,P=0.003)。相关及回归分析显示,FMD及NMD与颈动脉IMT及斑块发生率呈显著负相关,在校正年龄、性别、血压、血脂及血糖等相关混杂因素后,FMD及NMD仍是颈动脉IMT及斑块发生率的独立影响因素。结论轻度NAFLD组患者存在血管内皮功能损伤和颈动脉IMT增厚,NAFLD可能通过引起血管内皮功能紊乱导致动脉粥样硬化的发生。Objective To investigate correlation between the changes in cardiovascular endothelial function and carotid intima-media thickness(IMT)in patients with mild nonalcoholic fatty liver disease(NAFLD).Methods From January 2017 to February 2018,130 patients with mild NAFLD(NAFLD group)and 120 healthy adults(control group)were enrolled in hospital medical examination center.Endothelial diastolic function of brachial artery and carotid artery were assessed using color doppler echocardiography in all participants.Results The blood flow mediated dilation function(FMD)and nitroglycerin mediated dilation function(NMD)of brachial artery were significantly lower in NAFLD group than those in control group(11.92±3.28)%vs.(15.34±3.00)%and(17.64±2.28)%vs.(22.38±2.34)%,respectively,all P<0.001).The carotid artery IMT and the prevalence of carotid plaque were significantly higher in NAFLD group than those in control group(0.88±0.18)mm vs.(0.97±0.17)mm,P<0.001 and 36.9%vs.20.0%,P=0.003,respectively).The results of correlation and regression analysis showed that FMD and NMD were negatively correlated with carotid IMT and the prevalence of plaque.FMD and NMD were independent risk factors of carotid IMT and the prevalence of plaque after adjustment for age,sex,blood pressure,plasma lipids,and plasma glucose.Conclusion There were cardiovasclar endothelial dysfucntion and increased in carotid IMT in patients with mild NAFLD.Atherosclerosis might be induced by NAFLD via cardiovascular endothelial dysfunction.

关 键 词：非酒精性脂肪肝 血管内皮功能 颈动脉内-中膜厚度 彩色多普勒超声 

分 类 号：R575[医药卫生—消化系统] R445.1[医药卫生—内科学]