非酒精性脂肪肝与冠状动脉CT血流储备分数相关性的分析
Study on the correlation between non-alcoholic fatty liver and coronary CT angiography-derived fractional flow reserve
李莎 1张帅 2马文珊 2许天旗 1常凯 3史荣超 1王锡明1
作者信息
- 1. 山东大学 山东 济南 250012;山东省立医院医学影像科 山东 济南 250021
- 2. 山东省立医院医学影像科 山东 济南 250021
- 3. 山东省青岛市口腔医院麻醉手术科 山东 青岛 266000
- 折叠
摘要
目的 探讨非酒精性脂肪肝(NAFLD)与冠状动脉血流动力学异常之间的相关性.方法 选取行冠状动脉CT(CCTA)检查的患者 340例,根据肝/脾CT值比是否≤1.0分为NAFLD组(126例)及非NAFLD组(214例).比较两组一般资料、斑块性质、高危斑块及冠状动脉CT血流储备分数(coronary CT angiography-derived fractional flow reserve,CT-FFR)之间的差异.采用二元Logistic回归分析NAFLD与CT-FFR≤0.8 之间的相关性.结果 NAFLD组和非NAFLD组在糖尿病、高脂血症、冠状动脉疾病家族史、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)及尿酸水平等方面均差异有统计学意义(P<0.05).NAFLD组非钙化斑块、高危斑块及CT-FFR≤0.8 发生率均显著高于非NAFLD组,差异有统计学意义(P<0.05).多因素相关性分析结果显示,在调整传统心血管危险因素、钙化斑块、部分钙化、高危斑块及阻塞性斑块后,NAFLD仍是 CT-FFR≤0.8 的独立预测因子(OR:2.283;95%CI:1.156～4.507;P=0.017).结论 NAFLD与基于CCTA检测的冠状动脉血流动力学异常相关,独立于传统心血管危险因素及CCTA解剖学参数.
Abstract
Objective To explore the correlation between non-alcoholic fatty liver disease(NAFLD)and coronary artery he-modynamic abnormalities.Methods 340 patients who underwent CCTA examination from January 2016 to December 2018 were retrospectively enrolled.Patients were divided into NAFLD group(126)and non-NAFLD group(214)based on whether the liver/spleen CT value ratio was≤1.0.The differences were compared between the two groups in general information,plaque properties,high-risk plaques,and coronary CT angiography-derived fractional flow reserve(CT-FFR).The correlation between NAFLD and CT-FFR≤0.8 was analyzed using binary logistic regression.Results The study included 126 participants in the NAFLD group and 214 participants in the non-NAFLD group.The two groups were statistically different in terms of diabetes mel-litus,hyperlipidemia,family history of coronary artery disease,aspartate aminotransferase(AST),alanine aminotransferase(ALT),glutamyl transpeptidase(GGT),and uric acid levels(all P<0.05).Non-calcified plaques,high-risk plaques,and CT-FFR≤0.8 were significantly higher than those of non-NAFLD patients(all P<0.05).The results of multivariate correlation analysis showed that after adjusting for traditional cardiovascular risk factors,calcified plaques,partially calcified plaques,high-risk plaques,and obstructive plaques,NAFLD remained an independent predictor of CT-FFR≤0.8(OR:2.283;95%CI:1.156-4.507;P=0.017).Conclusion NAFLD is associated with abnormal coronary hemodynamics based on CCTA detection,independent of traditional cardiovascular risk factors and CCTA anatomic parameters.
关键词
非酒精性脂肪肝/冠状动脉CT血流储备分数/冠状动脉疾病/体层摄影术,X线计算机Key words
Non-alcoholic fatty liver disease/Coronary CT angiography-derived fractional flow reserve/Coronary artery dis-ease/Tomography,X-ray computed引用本文复制引用
出版年
2024
NETL
NSTL
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