酒精性脂肪性肝病患者颈动脉内膜中层厚度增加的影响因素分析  

Relationship between alcoholic fatty liver disease and carotid intima-media thickness and influencing factors for carotid intima-media thickness

作　　者：曲宝戈 王慧[1,2] 苏吉亮 王中东 王亚非 韩新海 刘元勋[1,2] 贾意国 潘锦敦 任光莺 

机构地区：[1]山东省泰山医院,山东泰安271000 [2]泰山医学院,山东泰安271000

出　　处：《临床肝胆病杂志》2015年第2期256-260,共5页Journal of Clinical Hepatology

基　　金：泰安市科技局资助课题(20123039)

摘　　要：目的探讨酒精性脂肪性肝病(AFLD)与颈动脉内膜中层厚度(CIMT)的关系及其影响因素。方法从2012年1月-2013年12月在山东省泰山医院住院及查体人群中选取饮酒男性136例和无饮酒史男性11例作为研究对象进行横断面研究。将其分为:轻度AFLD组(A组)45例;中重度AFLD组(B组)58例;无脂肪肝组(C组)44例。多个样本的均数比较采用单因素方差分析,两两比较若方差齐则采用LSD检验,若方差不齐则采用Tamhane's检验。结果 (1)B组人群CIMT明显高于C组(P=0.001)。(2)A组人群身体质量指数(BMI)明显高于C组(P=0.029)。A组和B组人群胆固醇(TC)、甘油三酯(TG)、极低密度脂蛋白(VLDL)、载脂蛋白(Apo)B和血尿酸(UA)均明显高于C组(P值均<0.05)。(3)A组人群GGT明显高于C组(P=0.001)。B组人群ALT、AST和GGT均明显高于C组(P值分别为0.023、0.003和0.000)。(4)A组和B组人群血肌酐(Cr)均明显低于C组(P值分别为0.007和0.005)。结论 AFLD可导致CIMT增厚,引起产生类代谢综合征样改变及肝肾功能异常,并且随着AFLD程度的加重,CIMT增厚更加明显,因此AFLD可用来作为预测人群发生CIMT增厚的指标。Objective To assess the relationship between alcoholic fatty liver disease （AFLD） and carotid intima - media thickness （ CI- MT） and the influencing factors for CIMT. Methods A cross - sectional study was conducted in 147 males who were inpatients or had physical examination at the Taishan Hospital in Shandong Province during January 2012 to December 2013. The participants, including 136 drinking cases and 11 non - drinking cases, were divided into mild AFLD group （ A, 45 cases） , moderate to severe AFLD group （ B, 58 ca- ses） , and non - AFLD group （ C, 44 cases）. Comparison of mean values between groups was performed using one - way ANOVA, and pair- wise comparisons were performed using the LSD test （for homogeneity of variance） or Tamhane＇s test （for heterogeneity of variance ）. Re- suits （ 1 ） CIMT was significantly higher in group B than in group C （ P = 0. 001 ）. （ 2 ） BMI was significantly higher in group A than in group C （P = 0. 029 ）. Total cholesterol, triglyeeride, very -low -density lipoprotein, apolipoprotein B, and uric acid levels significantly rose in groups A and B compared with group C （P 〈 0.05 ）. （3） Gamma- glutamyl transpeptidase （GGT） level was significantly higher in group A than in group C （ P = 0. 001 ）, whereas alanine transaminase, aspartate aminotransferase, and GGT levels were significantly higher in group B than in group C （ P = 0. 023, 0. 003, and 0. 000, respectively）. （4） Serum creatinine level was significantly lower in groups A and B than in group C （ P = 0. 007 and 0. 005, respectively）. Conclusion AFLD can cause the increase in CIMT, resulting in metabolic syndrome - like changes and liver/kidney dysfunction. With increasing severity of AFLD, CIMT increase becomes more significant. Thus, AFLD can be used as an indicator for predicting CIMT increase in human population.

关 键 词：脂肪肝 酒精性 动脉粥样硬化 代谢综合征X 

分 类 号：R575.5[医药卫生—消化系统]