| Objective: The non-alcoholic fatty liver disease(NAFLD) is a worldwide common disease. As a result of the improvement in living standard and the change of dietary structure, the incidence of NAFLD is increasing year by year. The relationship of NAFLD with metabolic syndrome(MS) has attracted people’s attention gradually, and the relationship of NAFLD with cardiovascular disease(CVD) has also become the research focus in recent years, requiring our continuous exploration and study. How could we manage to discover the disease early, so as to carry out the clinical prevention and treatment for it early, delay and even reverse the onset and development of it? Based on this problem, the paper will discuss the function and significance of N-terminal pro-brain natriuretic peptide(NT-pro BNP) and echocardiography in evaluating the development of cardiac function in patients with NAFLD, so as to provide reference for clinical practice.Methods: A total of 100 patients diagnosed as NAFLD in our hospital from January 2014 to September 2014 were selected as the experimental group, with 57 males and 43 females, whose age ranged from 32 to 75 years with an average of(54.4±10.4) years. Patients with pulmonary heart disease, cardiomyopathy, rheumatic heart disease and rheumatic valvular disease, patients who took drugs that may influence the concentration of plasma NT-pro BNP such as β-receptor blockers and angiotensin converting enzyme inhibitors in the recent period, as well as patients with notable clinical symptoms and signs of cardiac insufficiency were excluded. The NAFLD patients were divided into three groups based on the imaging examination of liver, with 51 cases in the mild group, 36 cases in the moderate group and 13 cases in the severe group.A total of 50 healthy individuals receiving health examination in our hospital were selected as the control group, with 31 males and 19 females, whose age ranged from 27 to 73 years with an average of(51.3±11.7) years. Patients had no severe organ diseases such as diseases of heart, liver, kidney and lung, and patients with viral hepatitis and alcoholism were excluded. There was no statistically significant difference between the two groups in age and gender. Both the two groups received NT-pro BNP test and color Doppler echocardiography examination, and the data were recorded for comprehensive comparison.Results: 1) For the NT-pro BNP of the experimental group, there were 40 cases of grade Ⅰ, 32 cases of grade Ⅱ, 15 cases of grade Ⅲ, 11 cases of grade Ⅳ and 2 normal cases. For the NT-pro BNP of the control group, there were 5 cases of grade Ⅰ, 2 cases of grade Ⅱ, 0 case of grade Ⅲ and grade Ⅳ, and 43 normal cases. The level of NT-pro BNP increased with the grade of NAFLD, and there was statistically significant difference among the mild, moderate and severe groups(P<0.05). The average left ventricular ejection fraction(LVEF) in patients with severe NAFLD was significantly lower than that in other three groups, and the level of NT-pro BNP in the experimental group was positively correlated with the grade of NAFLD. 2) Comparison of the color Doppler echocardiography results between the experimental group and the control group showed that in the experimental group, the average E/A ratio was significantly reduced, the incidence of diastolic cardiac dysfunction(DCD) was significantly increased, and the proportion of LVEF reduction was increased(P<0.05). 3) The cardiac function showed statistically significant difference among patients without NAFLD and patients with mild, moderate and severe NAFLD(P < 0.05). For the systolic function of heart, the proportion of LVEF reduction in patients with severe NAFLD was significantly higher than that in the other three groups(P<0.05), and the proportion of LVEF reduction in patients with moderate NAFLD was significantly higher than that in patients without NAFLD(P<0.05); the average LVEF in patients with severe NAFLD was significantly lower than that in the other three groups(P<0.05). For the diastolic function of heart, patients with severe or moderate NAFLD had lower E/A ratio and significantly higher incidence of DCD compared with patients without NAFLD or with mild NAFLD(P<0.05), and the E/A ratio in patients with severe NAFLD was significantly lower than that in patients with moderate NAFLD(P<0.05).Conclusion: The NAFLD is closely associated with cardiovascular diseases, which may cause damage to the cardiac function. The NT-pro BNP test combined with color Doppler echocardiography has high sensitivity and accuracy in diagnosing the cardiac function of patients with NAFLD. Both of them are common and convenient in clinical practice, and their advantages can be fully utilized. The combined examinations provide reliable basis for the early diagnosis and treatment of cardiac insufficiency in patients with NAFLD, and thus can be adopted as routine examinations in clinical practice. |
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