非酒精性脂肪性肝病患者炎症因子及内皮功能变化及意义  

Changes and significance of endothelial function and inflammatory factor in patients with non-alcoholic fatty liver disease

作　　者：张顺杰[1] 苏敏[1] 蒙钊[1] 李媛[1] 

机构地区：[1]钦州市第二人民医院消化内科,广西钦州535000

出　　处：《中华实用诊断与治疗杂志》2015年第1期70-72,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者炎症因子及内皮功能的变化及意义。方法 55例NAFLD患者(NAFLD组)和34例体检健康者(对照组),检测2组谷丙转氨酶(glutamic-pyruvic transaminase,GPT)、谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)、内皮素-1(endothelin 1,ET-1)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、一氧化氮(nitrogen monoxide,NO)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)水平;并行超声检查,观察2组肱动脉血流介导的内皮依赖性舒张(flow mediated vasodilation,FMD)功能;逐步线性回归分析FMD与各指标的相关性。结果NAFLD组TNF-α、IL-6、hs-CRP、HOMA-IR及ET-1分别为(32.56±6.40)ng/L、(38.87±3.89)ng/L、(18.19±5.66)mg/L、4.69±2.16、(239.53±15.69)ng/L),均高于对照组((9.38±3.12)ng/L、(7.54±2.38)ng/L、(5.56±3.07)mg/L、0.89±0.22、(50.34±10.78)ng/L)(P<0.05),FMD((7.86±1.07)%)、NO((27.28±8.42)μmol/L)低于对照组((12.70±2.68)%、(63.24±10.23)μmol/L)(P<0.05);逐步线性回归分析显示,FMD水平与hs-CRP(r=-0.462,P=0.008)、NAFLD(r=-0.528,P=0.045)、HOMA-IR(r=-0.324,P=0.018)呈负相关。结论 NAFLD与炎症、血管内皮功能障碍密切相关,NAFLD患者需及时进行血管内皮功能障碍干预,预防动脉粥样硬化发生。Objective To study the changes and significance of endothelial function and inflammatory factors in patients with non-alcoholic fatty liver disease（NAFLD）.Methods Fifty NAFLD patients（NAFLD group）and 34 healthy volunteers（control group）were detected the levels of serum glutamic-pyruvic transaminase（GPT）,glutamic-oxaloacetic transaminase（GOT）,endothelin-1（ET-1）,high sensitivity C-reactive protein（hs-CRP）,nitric oxide（NO）,total cholesterol（TC）,triacylglycerol（TG）,low density lipoprotein-cholesterol（LDL-C）,high density lipoproteincholesterol（HDL-C）,homeostasis model assessment of insulin resistance（HOMA-IR）,tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6）.The endothelium-dependent flow mediated dilatation（FMD）of brachial artery was observed on ultrasound.Stepwise linear regression analysis was used to analyze the correlation of FMD with various indexes.Results The levels of TNF-α,IL-6,hs-CRP,HOMA-IR and ET-1 were（32.56±6.40）ng/L,（38.87±3.89）ng/L,（18.19±5.66）mg/L,27.28±8.42and（239.53±15.69）ng/L in NAFLD group,higher than those in control group（9.38±3.12）ng/L,（7.54±2.38）ng/L,（5.56±3.07）mg/L,0.89±0.22,（50.34±10.78）ng/L）（P〈0.05）,and the levels of FMD and NO were lower in NAFLD group（（7.86±1.07）%,（27.28±8.42）μmol/L）than those in control group（（12.70±2.68）%,（63.24±10.23）μmol/L）（P〈0.05）.The liner stepwise regression analysis showed that FMD was negatively correlated with hs-CRP（r=-0.462,P=0.008）,NAFLD（r=-0.528,P=0.045）and HOMA-IR（r=-0.324,P=0.018）.Conclusion NAFLD is closely correlated with inflammation and vascular endothelial dysfunction.These patients need early intervention for endothelial dysfunction to prevent atherosclerosis.

关 键 词：非酒精性脂肪性肝病 炎症因子 内皮功能障碍 动脉粥样硬化 

分 类 号：R575.5[医药卫生—消化系统]