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Radiology:揭示冠状动脉斑块和非酒精性脂肪肝的内在关联

2014-11-07 佚名 生物谷

近日,来自哈佛大学医学院等处的研究人员利用冠状动脉成像技术(CCTA)揭示了高风险冠状动脉斑和常见肝病之间的紧密关联,相关研究刊登于国际杂志Radiology上。 此前研究显示CCTA可以检测出高风险冠状动脉斑或者易于危及生命的斑块;本文研究中研究者调查了高风险斑块和非酒精性脂肪性肝病(NAFLD)之间的关系,NAFLD的主要特点为肝功能异常,但并非和过度酒精摄入有关;NAFLD是最常见的一

近日,来自哈佛大学医学院等处的研究人员利用冠状动脉成像技术(CCTA)揭示了高风险冠状动脉斑和常见肝病之间的紧密关联,相关研究刊登于国际杂志Radiology上。

此前研究显示CCTA可以检测出高风险冠状动脉斑或者易于危及生命的斑块;本文研究中研究者调查了高风险斑块和非酒精性脂肪性肝病(NAFLD)之间的关系,NAFLD的主要特点为肝功能异常,但并非和过度酒精摄入有关;NAFLD是最常见的一种肝病,据估计一般人群中患该疾病的个体占到了20%至30%。

目前研究者很清楚动脉粥样硬化和炎症之间的关系,下一步就是揭示高风险的斑块和其它系统性的炎症比如NAFLD之间的关联。文章中研究人员对来自急诊科进行急性胸痛CCTA扫描的个体进行研究,这些患者会进行非强化的CT扫描来评估其冠状动脉钙量,冠状动脉钙量是动脉粥样硬化的标志物,同时对这些患者进行强化CCTA扫描来进行对比,研究人员就可以通过CCTA成像来对患者机体的高风险斑块进行评估。

在445名病人中,有182名患者(40.9%)有通过CT确定NAFLD的证据,在NAFLD患者中仅在59.3%的个体机体中发现了高风险斑块,而在非NAFLD的患者中仅有19%的个体存在高风险的斑块;当调整冠状动脉粥样硬化的程度、严重性及传统危险因素后,研究者发现NAFLD和高风险斑块表现出了持久性的关系。

高风险斑块和NAFLD军事系统性代谢障碍的主要症状表现,目前在临床上的意义包括利用非心脏CT扫描对比来全面评估NAFLD的进展。未来额外评估NAFLD和CT之间的关系或许可以帮助改善冠状动脉疾病患者的成层风险,当然这也正如本文研究的结果一样,揭示了NAFLD的存在和高风险冠状斑块之间的关联,而这种关系的存在是一种独立的传统风险因素。

后期研究人员希望通过更为深入的研究来解释为何NAFLD疾病在高风险冠状动脉粥样硬化病人中如此流行,目前一种理论认为所有的疾病症状都是系统性炎症引发的结果,而影响多种器官的炎性状态最终会危及个体的生命。

原始出处

Puchner SB1, Lu MT, Mayrhofer T, Liu T, Pursnani A, Ghoshhajra BB, Truong QA, Wiviott SD, Fleg JL, Hoffmann U, Ferencik M.High-Risk Coronary Plaque at Coronary CT Angiography Is Associated with Nonalcoholic Fatty Liver Disease, Independent of Coronary Plaque and Stenosis Burden: Results from the ROMICAT II Trial.Radiology. 2014 Nov 4

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