非酒精性脂肪肝与急性冠脉综合征关系的临床研究

摘要/Abstract

摘要：

目的：探讨非酒精性脂肪肝（NAFLD）与冠心病急性冠脉综合征（ACS）发病的关系。方法：收集2006年1月至2013年12
月因ACS住院的患者140例，将所有患者是否合并NAFLD分为NAFLD组（n=80）及非NAFLD组（n=60），通过血管超声结果比
较两组颈动脉斑块检出率。并将ACS分为3个临床亚组不稳定型心绞痛（UA）、急性ST段抬高心肌梗塞（STEMI）、急性非ST段
抬高心肌梗塞（NSTEMI），观察各亚组与NAFLD发病率有无差异性。比较NAFLD组和非NAFLD组甘油三酯（TG）、胆固醇
（TC）、低密度脂蛋白（LDL-C）的水平有无差异性。结果：ACS合并NAFLD组颈动脉斑块检出率明显高于非NAFLD组（85% vs
40%），两组比较差异有统计学意义（P<0.01）；ACS 3个亚组NAFLD发病率与非NAFLD发病率差异无统计学意义（P >0.05）；
NAFLD组TG、TC、LDL-C水平明显高于非NAFLD组（P <0.05）。结论：NAFLD患者存在出现颈动脉斑块及高脂血症的高风
险，是冠心病ACS的潜在危险因素，及时干预NAFLD患者可以在防治心血管疾病方面获益。

关键词: 非酒精性脂肪肝, 急性冠脉综合征, 颈动脉斑块

Abstract:

Objective: To study the correlation of non-alcoholic fatty liver disease（NAFLD）and acute coronary syndrome（ACS）
pathogenesis. Methods: One hundred and forty cases of ACS with NAFLD hospitalized in our hospital from January 2006 to December
2013 were divided into NAFLD group（n=80）and non NAFLD group（n=60）, the results were compared by vascular ultrasound
detection rate of carotid plaque. ACS was divided into three clinical subgroups of unstable angina pectoris（UA）, acute ST segment
elevation myocardial infarction（STEMI）, non ST segment elevation acute myocardial infarction（NSTEMI）. And the incidence of
NAFLD was observed in each subgroup. Riglyceride（TG）, cholesterol（TC）, low density lipoprotein（LDL- C） levers have no
difference in both NAFLD group and non NAFLD group. Results: The detection rate of carotid plaque in ACS combined with NAFLD
group was significantly higher than that in non NAFLD group（85% vs 40%）, there was significant difference between two groups（P<
0.01）; there was no statistically significant in the three subgroups of ACS the incidence of NAFLD and non NAFLD incidence rate
difference（P > 0.05）; group NAFLD, TG, TC, LDL-C level was significantly higher than that of non NAFLD group（P < 0.05）.
Conclusion: NAFLD patients have high risk carotid atherosclerosis and hyperlipidemia appears, which is a potential risk factor for
coronary heart disease ACS, timely intervention of NAFLD patients can be benefit in the prevention and treatment of cardiovascular
diseases.

Key words: non-alcoholic fatty liver disease, acute coronary syndrome coronary heart disease, carotid artery plaque

中图分类号:

R541.4

熊利平，刘正兴. 非酒精性脂肪肝与急性冠脉综合征关系的临床研究[J]. J4, 2015, 14(8): 18-21.

Xiong Liping, Liu Zhengxing. Clinical Study on Non-alcoholic Fatty Liver Disease and Acute Coronary Syndrome[J]. J4, 2015, 14(8): 18-21.

参考文献

〔1〕Truelsen T，Mahonen M，Tolonen H，et al.Trends in stroke
and coronary heart disease in the WHO MONICA Project〔J〕.
Stroke，2003，34（6）：1346-1352.
〔2〕Naghavi M，Libby P，Falk E，et al.From vulnerable plaque
to vulnerable patient：a call for new definitions and risk as?
sessment strategies：PartⅡ〔J〕. Circulation，2003，108（15）：
1772-1778.
〔3〕Kolodgie F D，Virmani R，Burke A P，et al. Pathologic.
assessment of the vulnerable human coronary plaque〔J〕.
Heart，2004，90（12）：1385-1391.
〔4〕中华医学会心血管病学分会，《中华心血管病杂志》编辑
委员会，《中国循环杂志》编辑委员会. 急性心肌梗死诊

断和治疗指南〔J〕. 中华心血管病杂志，2001，29（12）：
710-725.
〔5〕Braunwald E，Antman E M，Beasley J W，et al. ACC/AHA
2002 guideline update for the management of patients with
unstable angina and non-ST-segment elevation myocardial
infarction-summary article：a report of the American Col?
lege of Cardiology/American Heart Association task force
on practice guidelines（Committee on the Management of
Patients with Unstable Angina）〔J〕. Am Coll Cardiol，2002，
40（7）：1366-1374.
〔6〕李芳，余素翠，王琳.替罗非斑对急性冠脉综合征患者临
床症状和心电图的影响〔J〕.临床心血管病杂志，2004，
20（8）：466-467.
〔7〕Naghavi M，Libby P，Falk E，et al.From vulnerable plaque
to vulnerable patient：a call for new definitions and risk as?
sessment strategies：Part I〔J〕.Circulation，2003，108（14）：
1664-1672.
〔8〕中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非
酒精性脂肪性肝病诊断标准〔J〕. 中华肝脏病杂志，
2003，2（11）：71 -72.
〔9〕Ji H K，Kyoung I C，Seong M K，et al. Relationship between
Nonalcoholic Fatty Liver Disease and Carotiol Artery，Ath?
erosclerosis Beyond Matabolic Disorders in Non-Diabetic
Patients〔J〕. J Cardiovasc Ultrasound，2012，20（3）：126-
133.
〔10〕常显星，蒋兆彦，徐琛莹，等. 脂肪肝指数与非酒精性脂
肪性肝病和冠状动脉粥样硬化性心脏病的相关性研
究〔J〕.胃肠病学，2013，18（1）：6-10.
〔11〕周小莉，何兰杰，毕鹏翔.非酒精性脂肪肝与冠心病严
重性的相关性研究〔J〕.中华内分泌代谢杂志，2011，27
（9）：729-732.
〔12〕张晶，何胜虎，王雪飞.冠心病合并酒精性脂肪肝患者
冠状动脉病变特点分析〔J〕. 中国循证心血管医学杂
志，2014，6（1）：65-67.
〔13〕Tagher G，Bertolini L，Scala L，et al.Non-alcoholic hepat?
ic steatosis and its relation to increased plasma biomark?
ers of inflammation and endothelial dysfunction in non-di?
abetic men，role of visceral adipose tissue〔J〕. Diabet Med，
2005，22（10）：1354-1358.
〔14〕岳冬梅，刘龙，王凌燕.非酒精性脂肪肝与冠心病发病
的关系及可能机制〔J〕.中国老年学杂志，2012，9（32）：
3914-3916.
〔15〕中国成人血脂异常防治指南制定联合委员会.中国成
人血脂异常防治指南〔J〕.中华心血管病杂志，2007，35
（5）：390-413.