非酒精性脂肪性肝病患者肺功能变化临床分析  

A clinical study of pulmonary function changes in patients with nonalcoholic fatty liver disease

作　　者：陈志惠[1] 张世荣[1] 孙文静[1] 文良志[1] 刘凯军[1] 郭严[1] 魏艳玲[1] 王斌[1] 顾小红[2] 陈东风[1] CHEN Zhihui;ZHANG Shirong;SUN Wenjing;et al(Department of Gastroenterology, Research Institute of Filed Surgery, Daping Hospital, Army Medical University, Chongqing 400042, Chin)

机构地区：[1]陆军军医大学大坪医院野战外科研究所消化内科,重庆400042 [2]陆军军医大学大坪医院野战外科研究所健康管理科,重庆400042

出　　处：《临床肝胆病杂志》2018年第4期825-828,共4页Journal of Clinical Hepatology

摘　　要：目的分析探讨非酒精性脂肪性肝病(NAFLD)患者肺功能的变化及意义。方法选取2016年9月-2017年5月于陆军军医大学大坪医院体检中心进行体检的非酒精性脂肪性肝病(NAFLD)患者为NAFLD组(n=275),非NAFLD患者为对照组(n=276),对2组人群的肺功能资料进行分析,包括用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)及FEV1/FVC比值,同时对ALT升高的NAFLD组和ALT正常的NAFLD组的肺功能指标进行比较。计量资料方差齐者2组间比较采用两独立样本t检验,方差不齐则采用非参数Wilcoxon秩和检验。计数资料2组间比较采用χ2检验。结果 NAFLD组FVC、FEV1分别为(3.60±0.87)L、(2.97±0.79)L,均低于对照组的(3.87±0.80)L、(3.17±0.81)L,差异均有统计学意义(t值分别为-3.78、-2.87,P值均<0.01)。NAFLD组FEV1/FVC比值为(82.06±13.88)%,略低于对照组(82.88±13.0)%,但差异无统计学意义(P>0.05)。ALT升高的NAFLD组FVC、FEV1、FEV1/FVC分别为(3.53±0.82)L、(2.72±0.80)L、(81.21±13.00)%,均低于ALT正常的NAFLD组的(3.69±0.92)L、(3.06±0.79)L、(82.69±12.92)%,但差异均无统计学意义(P值均>0.05)。结论 NAFLD患者可能发生肺功能损害,与其代谢紊乱、肝脏炎症等因素有一定关系。Objective To investigate the pulmonary function changes in patients with nonalcoholic fatty liver disease（NAFLD） and their clinical significance.Methods A total of 275 NAFLD patients who underwent physical examination in Physical Examination Center of Daping Hospital,Army Medical University,from September 2016 to May 2017 were enrolled as NAFLD group,and 276 non-NAFLD patients were enrolled as control group.Pulmonary function data were analyzed for both groups,including forced vital capacity（FVC）,forced expiratory volume in the first second（FEV1）,and FEV1/FVC ratio,and pulmonary function parameters were compared between NAFLD patients with elevated alanine aminotransferase（ALT） and those with normal ALT.The two-independent-samples t test was used for comparison of continuous data with homogeneity of variance between groups,and the non-parametric Wilcoxon rank-sum test was used for comparison of continuous data with heterogeneity of variance between groups.The chi-square test was used for comparison of categorical data between groups.Results Compared with the control group,the NAFLD group had significantly lower FVC（3.60 ± 0.87 L vs 3.87 ± 0.80 L,t =-3.78,P 〈 0.01） and FEV1（2.97 ± 0.79 L vs 3.17 ± 0.82 L,t =-2.87,P 〈 0.01）.The NAFLD group had a slightly lower FEV1/FVC ratio than the control group（82.06% ＋ 13.88% vs 82.88% ± 13.0%,P 〉 0.05）.Compared with those with normal ALT,the NAFLD patients with elevated ALT had lower FVC（3.53 ± 0.82 L vs 3.69 ± 0.92 L,P 〉 0.05）,FEV1（2.72 ± 0.80 L vs 3.06 ± 0.79 L,P 〉 0.05）,and FEV1/FVC ratio（81.21% ± 13.00% vs 82.69% ± 12.92%,P 〉 0.05）.Conclusion NAFLD patients may have pulmonary function damage,which may be associated with metabolic disorder and liver inflammation.

关 键 词：非酒精性脂肪性肝病 肝炎 呼吸功能试验 

分 类 号：R575.5[医药卫生—消化系统]