非酒精性脂肪性肝病的预测指标及危险因素分析  

Analvsis of predictors and risk factors of non-alcoholic fatty liver disease

作　　者：薛黎[1,2] 孟存仁[1] 陈兆云[1] 张艳萍[2] 牛莉莉[3] 李建明[3] XUE Li, MENG Cun-ren, CHEN Zhao-yun, et al(Department of Laboratory Medicine, the First Affiliated Hospital, Xinjiang Medical University, Xinjiang Urumqi 83001)

机构地区：[1]新疆医科大学第一附属医院医学检验中心,新疆乌鲁木齐830011 [2]新疆医科大学第一附属医院昌吉分院检验科,新疆昌吉831100 [3]新疆昌吉州人民医院检验科,新疆昌吉831100

出　　处：《医学检验与临床》2017年第11期1-3,共3页Medical Laboratory Science and Clinics

基　　金：新疆昌吉市科学研究与技术开发计划项目：2016ZY-18.

摘　　要：目的：分析新疆昌吉市健康体检人群非酒精性脂肪性肝病（NAFLD）患者的一般资料,部分生化指标及相关危险因素.方法：调查2017年1月至2017年8月期间在新疆医科大学第一附属医院昌吉分院及昌吉州人民医院健康体检中被诊断的NAFLD患者981人和同期体检的正常人1081名,其中汉族1143人,回族512人,哈萨克族407人.男性1196例,女性866例,男女比例为1.38：1,年龄在18～70岁,平均年龄45.6岁.回顾性分析其一般检查和血生化检查数据.结果：病例组AST、ALT、GGT、BUN、CRE、UA、FPC、LDL-C、TG、CHOL、BMI、 收缩压、 舒张压等均显著高于对照组（P〈0.05）,而病例组HDL-C低于对照组（P〈0.01）.各因素的发生情况比较：病例组经常饮酒、 超重或肥胖、 糖尿病、 高血压病、 血脂异常等相关因素或疾病的患病率均显著高于对照组（均P〈0.01）,其中GGT升高发生率为61.96％,显著高于对照组22.60％（P〈0.01）.结论：NAFLD患者存在不同程度的肝、 肾功能异常和代谢紊乱;肥胖、 糖尿病、 高血压和血脂异常等因素与NAFLD关系密切,而高HDL-C水平是NAFLD的保护因素,在限制动脉壁胆固醇的积贮速度和促进其清除上起一定的作用.GGT轻度升高反映了代谢紊乱引起的肝细胞脂肪变性及损伤和肝纤维化,GGT测定可作为NAFLD的预测指标.Objective： This study was carried out to analyze the general information, some biochemical indexes and related risk factors of patients with non-alcoholic fatty liver disease （NAFLD） in Changji city of Xinjiang. Method： 981 patients with NAFLD and 1,081 normal people confirmed in physical examination in Changji branch of the First Affiliated Hospital of Xinjiang Medical University and Changji people＇s hospital during January 2017 to August 2017 were surveyed. Among which, 1,143 participants were the Han nationality, 512 were the Hui nationality and 407 were Kazak. There were 1,196 males and 866 females aged between 18 and 70 years with an average age of 45.6 years, and the male-female ratio was 1,38：1. The data of general examination and blood biochemistry were analyzed respectively. Results： AST, ALT, GGT, BUN, CRE, UA, FPC, LDL-C, TG, CHOL, BMI, systolic blood pressure and diastolic blood pressure in cases group were significantly higher than those in the control group （P〈0.05） , while HDL-C in cases group was lower than it in control group （P〈0.01） . The occurrence of related factors or diseases such as often drinking, overweight or obese, diabetes, hypertension, dyslipidemia were significantly higher than that of control group （all P〈0.01） , among them the occurring rate of elevated GGT was 61.96%, significantly higher than the control group 22.60%（P〈0.01） . Conclusion： Patients with NAFLD have different degrees of liver, renal dysfunction and metabolic disorders. Factors such as obesity, diabetes, hypertension and dyslipidemia are closely related to NAFLD, while the elevation of HDL-C is the protective factor of NAFLD, which plays a role in limiting the storage speed of the arterial wall cholesterol and promoting its clearance. Slightly elevated GGT reflect the fat degeneration, injury of liver cell and liver fibrosis caused by metabolic disorders, which can be used as a predictor of NAFLD.

关 键 词：非酒精性脂肪性肝病 生物化学指标 危险因素 

分 类 号：R575.5[医药卫生—消化系统]