超声量化诊断NAFLD与NASH的相关性及影响NASH发生的因素分析  

Relevance of quantitative ultrasonic diagnosis of nonalcoholic fatty liver disease to nonalcoholic steatohepatitis and analysis of factors related to nonalcoholic steatohepatitis

作　　者：谢海珊[1] 李翔[1] 余雪玲[1] 李泗玲[1] 

机构地区：[1]广州开发区医院,广东广州510730

出　　处：《临床和实验医学杂志》2011年第11期815-817,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的超声诊断非酒精性脂肪肝(NAFLD)患病率及分度,分析超声量化分度NAFLD与发生非酒精性脂肪性肝炎(NASH)的关系,分析影响NASH的发病因素。方法门诊健康体检的20～70岁人群进行肝脏B超检查和完整的临床问卷调查及血生化分析,超声发现脂肪肝者,进入临床诊断NAFLD和NASH。结果 1 216例进行肝脏B超检查、血生化分析并完成问卷调查,超声发现脂肪肝365例,检出率30.00%。诊断为NAFLD 279例,占脂肪肝76.44%。轻度NAFLD142例,占NAFLD的50.90%;中度NAFLD106例,占NAFLD的37.99%;重度NAFLD 31例,占脂肪肝的11.11%。其中116个患者诊断为NASH(占总体的9.53%,占超声诊断NAFLD的41.58%)。轻度NAFLD发生NASH45例,占31.69%;中度NAFLD发生NASH 60例,占56.60%;重度NAFLD发生NASH 26例,占83.87%。NASH的发生率与随超声量NAFTD脂肪肝程度增加而增高(P<0.05)。超声诊断NAFLD患病率与NASH发生率呈正相关,并随超声检查NAFLD分度增高而增高。Logistic回归分析超声诊断NAFLD中发生NASH与年龄、性别、肥胖、高脂血症、糖尿病的关系,发现年龄对NAFLD发生NASH无统计学意义。而性别、肥胖、高脂血症、糖尿病影响NAFLD中NASH的发生率(P<0.05)。结论超声检查NAFLD的分度与NASH的发生呈正相关,NAFLD病变程度越高NASH的发生率亦增高,超声量化诊断NASLF为NASH提供更为准备准确的诊断依据。性别、肥胖、高脂血症、糖尿病是影响NAFLD发生NASH的重要因素。Objective To investigate nonalcoholic fatty liver disease（NAFLD） and NAFLD degree by quantitative ultrasonic examination,analyze the correlation between NAFLD and nonalcoholic steatohepatitis（NASH） and epidemic factors related to the incidence of NASH.Methods Patients were recruited from medical examination in outpatient department.All patients completed clinical questionnaire,liver ultrasonic examination,and blood biochemical analysis.Results A total of 1 216 subjects（mean ag 54.6 years,rang 20~70） completed the questionnaire,ultrasound and blood laboratory examinations.Ultrasonic examination found fatty liver in 365 cases（30.00%）.Among ultrasonic fatty liver,NAFLD was found in 276 cases（76.44%） including mild NAFLD 142 cases（50.90% of NAFLD）,moderate NAFLD 106 cases（37.99% of NAFLD） and severe NAFLD 31 cases（11.11% of NAFLD）.Of NAFLD cases,NASH was confirmed in 116 cases（9.53% of the total cohort,41.58% of NAFLD） including 45 with mild NAFLD（31.69% of mild NAFLD）,60 with moderate NAFLD（56.60% of moderate NAFLD） and 26 with severe NAFLD（83.87% of severe NAFLD）.The incidence of NASH in ultrasonic severe NAFLD was significant higher than those in mild and moderate NAFLD,and the incidence of NASH in ultrasonic moderate NAFLD was higher than that in mild NAFLD（P0.05）.The incidence of NASH had positive correlation with the prevalence rate of ultrasonic NAFLD,and it increased with ultrasonic NAFLD grading.Logistic regression analysis indicated that age did not show influence on incidence of NASH,but hyperlipemia,sex,obesity and diabetes exhibited significant correlation with NASH（P0.05）.Conclusion The degree of NAFLD has a positive correlation with incidence of NASH.Therefore,quantitative ultrasonic diagnosis of NAFLD can provide an accurate method for the diagnosis of NASH in NAFLD patients.The study suggests hyperlipemia,sex,obesity and diabetes are important factors related to the incidence of NASH.

关 键 词：非酒精性脂肪肝 非酒精性脂肪性肝炎 超声检查 量化诊断 

分 类 号：R575[医药卫生—消化系统]