天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (3): 285-288.doi: 10.11958/20161437

• 临床研究 • 上一篇    下一篇

2 型糖尿病合并非酒精性脂肪肝患者发生心房纤颤的危险因素分析

路晓茅 1， 邸阜生 1， 2△   

  1. 1 天津医科大学三中心临床学院、 天津市第三中心医院分院 （邮编 300170）； 2 天津市第三中心医院、 天津市人工细胞重点实验室、 卫生部人工细胞工程技术研究中心
  • 收稿日期:2016-11-30 修回日期:2017-02-06 出版日期:2017-03-15 发布日期:2017-03-21
  • 通讯作者: 邸阜生 E-mail:lxm_tj81@sina.com

Risk factors of atrial fibrillation in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

LU Xiao-mao1, DI Fu-sheng1， 2△   

  1. 1 The Third Central Clinical Medical College of Tianjin Medical University, The Branch of Tianjin Third Central Hospital ,Tianjin 300170, China; 2 Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cells,Artificial Cell Engineering Research Center of Ministry of Health
  • Received:2016-11-30 Revised:2017-02-06 Published:2017-03-15 Online:2017-03-21
  • Contact: DI Fu-sheng E-mail:lxm_tj81@sina.com

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摘要： 摘要： 目的 探讨 2 型糖尿病合并非酒精性脂肪肝 （NAFLD） 患者发生心房纤颤 （AF） 的危险因素。方法 进行回顾性研究。选取 2014 年 9 月—2015 年 3 月天津市第三中心医院内分泌科住院的 2 型糖尿病合并 NAFLD 患者共153 例， 根据心电图结果分为 AF 组 （55 例） 和非 AF 组 （98 例）。收集患者临床资料， 比较 2 组间年龄、 性别、 血压、 血脂、 心功能和肝肾功能的差异， 并运用多因素 Logistic 回归筛选 2 型糖尿病合并 NAFLD 患者发生 AF 的危险因素。结果 AF 组年龄、 体质指数 （BMI）、 收缩压 （SBP）、 糖化血红蛋白 （HbA1c）、 总胆固醇 （TC）、 三酰甘油 （TG）、 低密度脂蛋白胆固醇 （LDL-C）、 谷氨酰转肽酶 （GGT）、 尿酸 （UA）、 B 型钠尿肽 （BNP）、 左房内径、 左室肥厚占比、 中性粒细胞/淋巴细胞比值（NLR）及 NAFLD 肝纤维化评分（NFS）较非 AF 组明显升高（P < 0.05）。多因素 Logistic 回归分析显示，高龄、 左室肥厚以及 TC、 GGT、 NLR、 NFS 升高是 2 型糖尿病合并 NAFLD 患者发生 AF 的危险因素。结论 炎症及纤维化改变可能是 NAFLD 及 AF 共同的病理过程， 2 型糖尿病合并 NAFLD 患者应予以严格的血脂控制、 改善体内长期慢性炎症状态， 防止 AF 的发生。

关键词: 糖尿病, 2 型, 脂肪肝, 心房颤动, 危险因素, 炎症, 血脂异常, 非酒精性脂肪肝, 中性粒细胞/淋巴细胞比值, NAFLD 肝纤维化评分

Abstract: Abstract: Objective To investigate the risk factors of atrial fibrillation (AF) in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease (NAFLD). Methods A retrospective study was conducted. A total of 153 patients with type 2 diabetes and NAFLD who were hospitalized in the department of endocrinology of Tianjin Third Central Hospital from September 2014 to March 2015 were selected. According to the results of electrocardiogram, patients were divided into AF group (n=55) and non-AF group (n=98). The clinical data were collected to compare the differences of age,gender, blood pressure, blood lipids, heart function and liver and kidney functions between the two groups. The multivariate Logistic regression was used to screen the risk factors of AF in patients with type 2 diabetes mellitus complicated with NAFLD. Results The age, body mass index (BMI), systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), gamma glutamyltransferase (GGT), uric acid (UA), B type natriuretic peptide (BNP), left atrial diameter, left ventricular hypertrophy on the electrocardiogram diagnosis rate, the neutrophil/lymphocyte ratio (NLR) and NAFLD fibrosis score (NFS) were significantly higher in AF group than those of non-AF group (P < 0.05). Multivariate Logistic analysis showed that the advanced age, left ventricular hypertrophy and high levels of TC, GGT, NLR and NFS were the risk factors for AF in patients with type 2 diabetes mellitus and NAFLD.Conclusion Inflammation and fibrosis may be the common pathological process of NAFLD and atrial fibrillation. Patients with type 2 diabetes mellitus complicated with NAFLD should control blood lipids strictly and improve the long- term chronic inflammatory state to prevent the occurrence of AF.

Key words: diabetes mellitus, type 2, fatty liver, atrial fibrillation, risk factors, inflammation, dyslipidemias, nonalcoholic fatty liver, NLR, NFS