老年非酒精性脂肪性肝病合并冠心病患者临床特点及危险因素分析*

doi:10.3969/j.issn.1672-5069.2021.05.025

摘要/Abstract

摘要： 目的探讨老年非酒精性脂肪性肝病(NAFLD)患者合并冠心病(CHD)的临床特点及危险因素。方法 2018年5月～2020年6月我院收治的186例老年NAFLD患者,接受冠状动脉造影诊断冠心病,采用单因素和多因素Logistic回归分析合并CHD的影响因素。结果在186例老年NAFLD患者中,75例(40.3%)合并CHD;CHD组合并糖尿病、高血压、吸烟和空腹血糖(FPG)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL-C)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和胰岛素抵抗指数(HOMA-IR)与非CHD组比,差异均有统计学意义(P均<0.05);经多因素Logistic回归分析结果显示,BMI超标、合并糖尿病、血清FPG、TC、TG和LDL-C水平均为老年NAFLD患者合并CHD的独立危险因素(P均<0.05)。结论老年NAFLD患者合并CHD发生率较高,并存在显著的独立危险因素,需做好针对性的筛查和防治,以减少CHD的发生,提高老年人生活质量。

关键词: 非酒精性脂肪性肝病, 冠心病, 临床特点, 危险因素, 老年

Abstract: Objective The aim of this study was to investigate the clinical feature and risk factors of elderly patients with nonalcoholic fatty liver diseases (NAFLD) and concomitant coronary heart disease (CHD). Methods The clinical data of 186 elderly patients with NAFLD admitted to our hospital between May 2018 and June 2020 were retrospectively analyzed, and all patients underwent coronary angiography. The univariate and multivariate Logistic regression analysis was applied to reveal the influencing factors of CHD in elderly NAFLD patients. Results Among 186 elderly patients with NAFLD, 75 (40.3%) patients had concomitant CHD; the percentage of diabetes mellitus, hypertension, smoking and fasting blood glucose (FPG), total blood cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, and insulin resistance index (HOMA-IR) in patients with CHD were significantly different as compared to those in patients without CHD (all P <0.05); the multivariate Logistic regression analysis showed that the increased BMI, concomitant diabetes mellitus, high blood FPG, TC, TG, and LDL-C levels were the independent risk factors for CHD in elderly NAFLD patients (all P < 0.05). Conclusion The incidence of CHD in elderly patients with NAFLD is high, and the related risk factors should be early under surveillance and appropriately controlled to improve thequality of life in elderly patients with NAFLD.

Key words: Nonalcoholic fatty liver diseases, Coronary heart disease, Clinical features, Risk factors, Elderly

马上吉, 郑扬, 陈旭峰, 向正国, 吴琳. 老年非酒精性脂肪性肝病合并冠心病患者临床特点及危险因素分析^*[J]. 实用肝脏病杂志, 2021, 24(5): 705-708.

Ma Shangji, Zheng Yang, Chen Xufeng, et al. Clinical feature and risk factors of elderly patients with nonalcoholic fatty liver diseases and concomitant coronary heart disease[J]. Journal of Practical Hepatology, 2021, 24(5): 705-708.

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老年非酒精性脂肪性肝病合并冠心病患者临床特点及危险因素分析^*

Clinical feature and risk factors of elderly patients with nonalcoholic fatty liver diseases and concomitant coronary heart disease

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