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目的:颈动脉粥样硬化是冠心病重要的独立危险因素。本文通过对非酒精性脂肪肝病与颈动脉内膜中层厚度及颈动脉斑块相关研究的Meta分析,来探讨非酒精性脂肪肝病与颈动脉粥样硬化的关系。方法:检索2004年-2015年发表的关于非酒精性脂肪肝病与颈动脉内膜中层厚度关系的病例对照研究文献,根据纳入、排除标准筛选文献,提取相关数据,应用软件进行统计分析。结果:共纳入文献7篇,累积样本量1168例(病例组504例/对照组664例)。非酒精性脂肪肝病与颈动脉内膜中层厚度关系的研究之间存在显著异质性,经过Meta回归分析,γ-谷氨酰转移酶水平的差异可解释全部异质性。经随机效应模型计算合并颈动脉内膜中层厚度均值差为0.18mm,95%可信区间[0.12,0.25]。非酒精性脂肪肝病与颈动脉粥样斑块关系的研究之间无异质性,经固定效应模型计算合并OR值3.51,95%可信区间[2.53,4.86]。纳入的研究不存在发表偏倚。结论:非酒精性脂肪肝病患者的颈动脉内膜中层厚度较对照组大致增加0.18mm,其出现颈动脉粥样斑块的危险是对照组的3.51倍。有必要常规对非酒精性脂肪肝病患者进行颈动脉超声检查,评估其心血管疾病发病的危险。
Objective: Carotid atherosclerosis is an important independent risk factor for coronary heart disease. This article discusses the relationship between non-alcoholic fatty liver disease and carotid atherosclerosis by Meta-analysis of non-alcoholic fatty liver disease and carotid intima-media thickness and carotid plaque. Methods: A case-control study on the relationship between non-alcoholic fatty liver disease and carotid artery intima-media thickness published from 2004 to 2015 was retrieved. According to the inclusion and exclusion criteria, the relevant literature was extracted and the software was used for statistical analysis. Results: A total of 7 articles were included, with a cumulative sample size of 1,168 cases (504 in case group / 664 in control group). There is a significant heterogeneity between the non-alcoholic fatty liver disease and carotid artery intima-media thickness, and the heterogeneity can be explained by Meta-regression analysis and differences in γ-glutamyl transferase levels. The mean difference of carotid artery intima-media thickness was 0.18mm, 95% confidence interval [0.12,0.25] calculated by random effect model. Non-alcoholic fatty liver disease and carotid atherosclerotic plaque no heterogeneity between the fixed effect model calculated combined OR 3.51,95% confidence interval [2.53,4.86]. Included in the study is publication bias. Conclusion: The carotid intima-media thickness of patients with non-alcoholic fatty liver disease increased by 0.18mm compared with the control group, and the risk of developing carotid artery plaque was 3.51 times that of the control group. It is necessary to conduct routine carotid ultrasound in patients with non-alcoholic fatty liver disease to assess the risk of cardiovascular disease.