非酒精性脂肪肝人群合并胆囊结石病发生危险因素分析  

Risk factors analysis of non-alcoholic fatty liver disease combined with gallstone disease

作　　者：史会连 田文君 乔飞 郭海燕 邵铭 SHI Huilian;TIAN Wenjun;QIAO Fei;GUO Haiyan;SHAO Ming(Department of Infectious Disease,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029,China;Department of Infectious Disease,Nanjing Hospital of Chinese Medicine,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京中医药大学附属医院感染科,江苏南京210029 [2]南京市中医院感染科,江苏南京210000

出　　处：《安徽医药》2019年第10期2057-2061,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析非酒精性脂肪肝(non?alcoholic fatty liver disease,NAFLD)病人的临床特征,并分析其与胆囊结石病(gall?stone disease,GD)的危险因素。方法回顾分析2016年1月至2017年1月在南京中医药大学附属医院门诊或住院的NAFLD病人405例的基本信息、既往史、实验室检查、瞬时弹性B超等临床资料,两组间比较用单因素分析,非条件二分类logistic回归分析筛选NAFLD合并GD的危险因素。结果共纳入符合入选标准者405例,其中GD病人85例,非GD病人320例,两组病人在女性、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、体质量指数(body mass index,BMI)、糖尿病、肝脏硬度测定值(liver stiffness measurement,LSM)方面差异有统计学意义(P<0.05),通过多因素分析,得出糖尿病(OR=2.10,95%CI:1.25~3.52),BMI(OR=1.09,95%CI:1.02~1.17)及瞬时弹性超声的LSM>9.8 kPa(OR=3.08,95%CI:1.49~6.36)是NAFLD合并GD的危险因素。结论当NAFLD合并GD时,女性多见,BMI偏高,患有糖尿病者多,ALT异常多见;合并GD的NAFLD病人较单纯NAFLD病人肝功能受损更明显,肝纤维化程度更严重。糖尿病、高BMI及瞬时弹性超声的LSM>9.8 kPa是NAFLD合并GD的危险因素。Objective To analyze the clinical features of patients with non?alcoholic fatty liver disease(NAFLD)and to analyze the relative risk factors between NAFLD and gallstone disease(GD).Methods Clinical data of 405 NAFLD outpatients or inpa?tients who were treated at The Affiliated Hospital of Nanjing University of Chinese Medicine between January 2016 and January 2017 were retrospectively analyzed,including basic information,previous medical history,laboratory examination,and transient b?ul?trasound elastography.The patients were assigned into NAFLD group and NAFLD+GD group.The two groups were compared to screen the risk factors by single factor analysis and logistic regression analysis.Results A total of 405 patients were included in the study,including 85 GD patients and 320 non?GD patients.There were significant differences between the two groups in females,alanine aminotransferase(ALT),body mass index(BMI),diabetes and liver stiffness measurement(LSM,P<0.05).Multivariate analysis showed that the risk factors for NAFLD combined with GD were diabetes(OR=2.10,95%CI:1.25?3.52),BMI(OR=1.09,95%CI:1.02?1.17)and LSM>9.8 kPa(OR=3.08,95%CI:1.49?6.36).Conclusions When NAFLD is combined with GD,women are more common.Patients with NAFLD and GD are characterized with higher BMI,diabetes diseases and abnormal ALT.Patients with NAFLD and GD are more prone to severely impaired liver function and more serious liver fibrosis compared with sin?gle NAFLD patients.In conclusion,diabetes,high BMI and LSM>9.8 kPa are risk factors for NAFLD with GD.

关 键 词：脂肪肝 胆囊结石病 危险因素 弹性成像技术 

分 类 号：R57[医药卫生—消化系统]