冠心病合并非酒精性脂肪肝患者心肺运动试验特点  

Characteristics of cardiopulmonary exercise test in patients with coronary heart disease and non-alcoholic fatty liver disease

作　　者：骆雪 王曦[1] LUO Xue;WANG Xi(Department of Cardiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016

出　　处：《临床心血管病杂志》2023年第2期145-149,共5页Journal of Clinical Cardiology

摘　　要：目的:比较冠心病和冠心病合并非酒精性脂肪肝(NAFLD)患者心肺运动试验指标的特点,探讨NAFLD对冠心病患者心肺耐力的影响。方法:选取2018年3月—2022年3月于重庆医科大学附属第一医院心内科住院行心肺运动试验的慢性稳定期冠心病患者122例,其中61例合并NAFLD为NAFLD组,61例无脂肪肝为对照组,比较两组患者运动心肺核心指标的差异。结果:122例冠心病患者平均峰值公斤摄氧量(Peak VO_(2)/kg)为(17.89±3.82)mL·kg^(-1)·min^(-1),102例(83.6%)患者无氧阈下代谢当量(AT-METs)<5 MET。其中NAFLD组Peak VO_(2)/kg、无氧阈(AT)、AT-METs均低于对照组(均P<0.05)。Spearman相关检验分析提示,NAFLD与Peak VO_(2)/kg、AT、AT-MET均呈显著负相关(r=-0.331、-0.274、-0.266,均P<0.01)。多元线性回归分析显示,NAFLD是冠心病患者心肺耐力下降的独立危险因素(P<0.05)。结论:NAFLD合并冠心病患者的心肺功能下降显著。Objective:To compare the indexes of cardiopulmonary exercise test(CPET)between patients with coronary heart disease and patients with coronary heart disease complicated with non-alcoholic fatty liver disease(NAFLD),and to explore the effect of NAFLD on cardiopulmonary fitness in patients with coronary heart disease.Methods:A total of 122 patients with stable coronary heart disease who were hospitalized in the Department of Cardiology,the First Affiliated Hospital of Chongqing Medical University from March 2018 to March 2022 were selected.Among them,61 cases with NAFLD were divided into the NAFLD group and 61 cases without NAFLD as the control group.The differences in the core indexes of CPET between the two groups were compared.Results:The average Peak VO_(2)/kg in 122 patients with coronary heart disease was(17.89±3.82)mL·kg^(-1)·min^(-1),and the subthreshold metabolic equivalent(AT-METs)in 102 patients(83.6%)was lower than 5 MET.The Peak VO_(2)/kg,anaerobic threshold(AT),and AT-METs in the NAFLD group were lower than those in the control group(all P<0.05).Spearman correlation analysis showed that NAFLD was negatively correlated with PeakVO_(2)/kg,AT,and AT-MET(r=-0.331,-0.274,-0.266,all P<0.01).Multiple linear regression analysis showed that NAFLD was an independent risk factor for cardiopulmonary fitness in patients with coronary heart disease(P<0.05).Conclusion:Cardiopulmonary fitness is significantly decreased in patients with coronary heart disease complicated with NAFLD.

关 键 词：冠心病 非酒精性脂肪肝 心肺运动试验 心肺耐力 

分 类 号：R541.4[医药卫生—心血管疾病]