慢性乙型肝炎患者合并肝脂肪变性危险因素的病例对照研究  

Risk factors for hepatic steatosis in patients with chronic hepatitis B：a case-control study _

作　　者：陈靖[1] 董菁[1] 林海端[1] 江家骥[1] 

机构地区：[1]福建医科大学附属第一医院肝病中心,福州350005

出　　处：《中华全科医师杂志》2010年第10期683-686,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨慢性乙型肝炎（CHB）肝脂肪变性的危险因素。方法180例经肝活检的CHB患者，其中合并肝脂肪变性患者与无肝脂肪变性患者按照性别相同、年龄±3岁进行1：1匹配，分为病例组（61例，合并肝脂肪变性）与对照组（61例，无脂肪变性），进行病例对照分析，探讨肝脂肪变性的危险因素。结果病例组体重指数24±3，显著高于对照组22±3（P〈0．01），而空腹血糖、总胆固醇、甘油三酯、尿酸、丙氨酸氨基转移酶、γ-谷氨酰转肽酶及乙型肝炎病毒（HBV）DNA水平与对照组差异均无统计学意义（均P〉0．05）。经COX模型拟合进行配对资料logistic回归分析，仅体重指数为肝脂肪变性的独立危险因素（OR=1．488，P〈0．01）。结论CHB患者肝脂肪变性与宿主体重指数有关，而与HBVDNA水平无关。Objective To investigate risk factors for hepatic steatosis in patients with chronic hepatitis B （CHB）. Methods One hundred and eighty patients with biopsy-proven chronic hepatitis B were included in the study. Those with liver steatosis （61 from 93 cases） and those without it （61 from 87 cases） were matched on gender and age （ ± 3 years）. Results Body mass index （BMI） was significantly higher in case group （24 ±3） than that in controls （22 ±3） （P 〈0.01）. No significant difference was found in fasting plasma glucose, total cholesterol, triglycerides, urine acid, alanine aminotransferase, glutamyl transpeptidase and hepatitis B virus （ HBV ） DNA between the cases and controls （ all P 〉 0. 05 ） . Conditional logistic regression analysis with proportional hazard regression model statement by SPSS software showed that BMI was the only independent correlate to liver steatosis in patient with CHB （ OR = 1. 488, P 〈 0. 01 ）. Conclusions Liver steatosis in patients with CHB associates with BMI of the hosts, but does not correlate to their HBV DNA level.

关 键 词：肝炎 乙型 慢性 脂肪肝 危险因素 

分 类 号：R575[医药卫生—消化系统] R51[医药卫生—内科学]