[慢性心力衰竭合并代谢综合征患者肝纤维化的预测]。

O M Drapkina, E V Zyatenkova
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引用次数: 0

摘要

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)是目前公认最常见的慢性肝病。27.8%的NAFLD患者有心血管系统疾病,这是NAFLD患者死亡的主要原因。目的:探讨代谢综合征合并慢性心力衰竭(CHF)患者发生肝纤维化的可能性。材料与方法:纳入77例CHF患者。经NT-proBNP定性测定,确诊为CHF。评估患者心衰临床表现的严重程度、功能状态。所有患者均行临床及血液生化检查、心电图、肝脏超声检查。超声心动图检查心室大小、心肌壁厚及心外膜脂肪。NAFLD纤维化评分(NFS)对所有参与研究的患者进行计算。结果:研究组患者NFS值与体重有直接相关性(r = 0,38;P = 0.001),血糖水平(r = 0,54;P = 0.001),糖化血红蛋白水平(r = 0,51;p = 0.002),左室心肌质量(r = 0.51;p = 0.005),右心房大小(RA) (r = 0,45;p = 0.013),左心房大小(LA) (r = 0,41;P = 0.023)。NFS值与总胆固醇呈负相关(r = -0,43;p = 0,008),心外膜脂肪厚度(EFT) (r = 0,29;p = 0.014),舒张末期(CD)左室大小(r = 0,27;p = 0.02)、收缩期末期(CS)、左心室大小(r = 0.27;p = 0.02), CD心室容积(r = 0,25;p = 0,02), CS LV容积(r = 0,28;P = 0,02)。NFS与6分钟步行测试(6MWT)相关(p = 0.023;U-Mann-Whitney)。在内科常规实践中使用NAFLD纤维化评分有助于在疾病早期以无创方式识别NAFLD合并心血管疾病患者,并在必要时调整当前的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[PREDICTION OF LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND METABOLIC SYNDROME].

Currently, the non-alcoholic fatty liver disease (NAFLD) is recognized as the most common chronic liver disease. 27.8% of patients with NAFLD have diseases of the cardiovascular system (cardiovascular), which are the leading cause of death in patients with NAFLD.

Objective: To study the probability of liver fibrosis in patients with metabolic syndrome and chronic heart failure (CHF).

Materials and methods: The study included 77 patients with CHF. The diagnosis of CHF was confirmed by the qualitative measurement of NT-proBNP. The severity of the clinical manifestations of heart failure, functional status of the patient was assessed. All patients underwent clinical and biochemical blood tests, ECG, ultrasound examination of the liver. The size of the heart chambers, wall thickness of the myocardium and epicardial fat were evaluated by echocardiography. The NAFLD Fibrosis Score (NFS) was calculated in all patients enrolled in the study.

Results: In the study group patients The direct correlations between the value of NFS: weight (r = 0,38; p = 0,001), glucose levels (r = 0,54; p = 0,001), the level of glycosylated hemoglobin (r = 0,51; p = 0,002), LV myocardium mass (r = 0, 51; p = 0,005), the sizes of the right atrium (RA) (r = 0,45; p = 0,013), sizes of the left atrium (LA) (r = 0,41; p = 0,023) were found in the study group patients. Inverse correlation between the value of NFS: total cholesterol (r = -0,43; p = 0,008), epicardial fat thickness (EFT) (r = 0,29; p = 0,014), end-diastolic (CD) left ventricular size (r = 0,27; p = 0,02), end-systolic (CS), left ventricular size (r = 0,27; p = 0,02), CD ventricular volume (r = 0,25; p = 0,02), CS LV volume (r = 0,28; p = 0,02). NFS is correlated with the six-minute walk test (6MWT) (p = 0,023; U-Mann-Whitney). Using the NAFLD fibrosis score in internist routine practice help to identify patients with NAFLD and cardiovascular diseases by non-invasive way in the early stages of the disease and to adjust the current treatment, if necessary.

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