冠心病伴发非酒精性脂肪性肝病的危险因素分析

目的探讨冠心病伴发非酒精性脂肪性肝病(NAFLD)的患病率和危险因素。方法 1346例经冠状动脉造影诊断为冠心病的患者入院期间进行空腹肝胆超声检查,分为NAFLD组和非NAFLD组,观察NAFLD的发生率、肝功能酶学异常比例及其与冠状动脉病变程度的关系。结果 NAFLD的发生率为50.4%(678/1346)。NAFLD组合并糖尿病、空腹血糖、血清总胆固醇、甘油三酯、谷丙转氨酶及谷草转氨酶水平高于无NAFLD组(P<0.01)。NAFLD的发生率随着冠状动脉病变程度的加重而增加(P<0.01)。多因素Logistic回归分析显示,糖尿病和冠心病多支病变(或左主干病变)是NAFLD的独立危险因素。结论冠心病患者NAFLD的发生率随着冠状动脉粥样硬化病变程度的加重而增加,尤其是糖尿病患者。

Analysis of Risk Factors for Coronary Heart Disease Complicated with Non-alcoholic Fatty Liver Disease

Aim To investigate the incidence and risk factor of coronary heart disease complicated with non-alcoholic fatty liver disease (NAFLD) in patients undergoing coronary angiogram. Methods 1346 patients with coronary heart disease who underwent coronary angiogram were enrolled into this study. All patients had ultrasound screening for fatty liver. Results Among 612 recruited patients, 678 (50.4%5) had fatty liver by ultrasonography. Incidence of NAFLD in the patients in 3-vessel disease was higher than those of 1, 2-vessel disease (P<0.01). By multivariable Logistic regression analysis, diabetes mellitus, multi-vessel lesions or stenosis of left main stem were risk factors in NAFLD patients with coronary heart disease. Conclusion In coronary heart disease patients, increase in the incidence of NAFLD were related to coronary atherosclerosis severity aggravating, especially the patients with diabetes mellitus.