胆囊疾病对非酒精性脂肪性肝病患者心脏舒张功能的影响

摘要

Objective To evaluate changes of the cardiac diastolic function in patients with nonalcoholic fatty liver disease (NAFLD) with color Doppler Echocardiography and analyze the influence of gallbladder diseases on the cardiac diastolic function in patients with NAFLD. Methods From July 2005 to June 2008, one hundred and twenty patients with NAFLD and 120 matched healthy controls in our hospital were included in this study. In 120 NAFLD patients, 46 patients had chronic cholecystitis, 20 patients had gallstone. All the 240 subjects were examined with B Ultrasound for fatty liver diagnosis and color Doppler Echocardiography for the evaluation of cardiac diastolic function. The E/A ratio less than 1 in color Doppler Echocardiography was defined as diastolic cardiac dysfunction (DCD). Results The percentage of DCD in NAFLD patients with chronic cholecystitis or gallstone was significantly higher than that in NAFLD patients without chronic cholecystitis or gallstone, respectively (x2 = 42.24 or x2 = 18. 034, P = 0. 001 ). Logistic analysis showed that the degree of fatty liver, chronic cholecystitis and serum GGT level were independently risk factors for the E/A ratio in NAFLD patients (P =0. 001 ). Conclusion Not only NAFLD, but also chronic cholecystitis, are novel risk factors for DCD or coronary artery disease.%目的 应用彩色多普勒超声心动图技术评价非酒精性脂肪性肝病(NAFLD)患者心脏舒张功能的变化,并分析慢性胆囊炎、胆囊结石对NAFLD患者心脏舒张功能的影响.方法 2005年7月~2008年6月我院120例NAFLD患者和120例配对的健康对照者被纳入研究.120例NAFLD患者中,慢性胆囊炎46例,胆囊结石20例.采用B超对患者进行脂肪肝的诊断,应用彩色多普勒超声心动图技术评价心脏的舒张功能,E/A比值小于1被定义为心脏舒张功能不全(DCD).结果 患有慢性胆囊炎或胆囊结石的NAFLD患者的DCD发生率明显高于无慢性胆囊炎或无胆囊结石的NAFLD患者(χ2=42.24或χ2=18.034,P=0.001).Logistic回归分析显示,脂肪肝程度、慢性胆囊炎、血清GGT水平是E/A比值的独立危险因素(P=0.001).结论 NAFLD患者中慢性胆囊炎可能是DCD或冠心病新的危险因素.