非酒精性脂肪性肝病对冠心病患者心脏功能的影响

目的对冠心病(CHD)患者联合进行肝脏B超检测和心脏彩色多普勒超声的检查,以观察非酒精性脂肪性肝病(NAFLD)对冠心病患者心脏功能的可能影响。方法 2005年7月-2010年12月在我院经冠状动脉造影确诊为冠状动脉硬化性心脏病的406例患者纳入本研究。对这些患者在冠状动脉造影前后3天内进行了肝脏的B超检查与心脏彩色多普勒超声检查。结果共发现NAFLD 208例(51.2%)。伴有NAFLD的CHD患者的舒张功能不全(DCD)、左室射血分数(LVEF)下降的比例明显高于不伴NAFLD患者;随着脂肪肝的加重,CHD患者的E/A比值逐步下降,DCD发生率逐步上升,LVEF下降比例也逐步升高。结论伴有NAFLD的CHD患者的心脏功能明显下降,舒张功能下降更为明显,提示NAFLD是CHD患者心脏功能的危险因素之一。

Influence of nonalcoholic fatty liver disease on the cardiac function in patients with coronary atherosclerotic heart disease

Objective To investigate the influence of nonalcoholic fatty liver disease(NAFLD) on the cardiac function in patients with coronary atherosclerotic heart disease(CHD) with color doppler echocardiography and B ultrasound.Methods From July 2005 to December 2010,406 patients with CHD in our hospital enrolled in this study.All subjects were examined with B ultrasound for fatty liver diagnosis and color doppler echocardiography for the evaluation of cardiac function.The E/A ratio in color doppler echocardiography was used to evaluate the cardiac diastolic function,and the left ventricular ejecting fraction(LVEF) was used as marker for cardiac systolic function.Results Among 406 CHD patients,208 patients had NAFLD.The percentage of diastolic cardiac dysfunction(DCD) and decreased LVEF in CHD patients with NAFLD were 33.7%,15.9% respectively,significantly higher than 12.1%,8.1% in CHD patients without NAFLD(P=0.02,P=0.04).As the fatty liver progressed,the E/A ratio decreased and percentage of DCD increased stepwisely(P=0.01),and the percentage of DCD and decreased LVEF in CHD patients also increased.Conclusion The cardiac function in CHD patients with NAFLD often decreases,especially the diastolic function.NAFLD may be associated with CHD or be one of the risk factors for CHD.