多学科协作模式在非酒精性脂肪性肝病诊治中的应用价值  

Application value of multidisciplinary cooperation model in the diagnosis and treatment of nonalcoholic fatty liver disease

作　　者：库尔班妮萨·吾拉音 苏桂华[1] 吴李贤 阿不里克木·吐尔松[1] 吴超[1] Kurbanissa·Wulayin;SU Gui-hua;WU Li-xian;Abrikmu·Tulson;WU Chao(Department of Infectious Diseases,the First People’s Hospital of Kashgar,Kashgar 844000,China;Department of Infectious Diseases,Foshan Hospital,Sun Yat-sen University,Foshan 528000,China)

机构地区：[1]喀什地区第一人民医院感染科,844000 [2]中山大学附属佛山医院感染科,528000

出　　处：《现代消化及介入诊疗》2021年第11期1373-1377,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：新疆维吾尔自治区自然科学基金(2019D01C008)。

摘　　要：目的探讨多学科协作(MDT)模式在非酒精性脂肪性肝病(NAFLD)诊治中的应用价值。方法前瞻性选取2019年6月至2020年6月喀什地区第一人民医院感染科诊治的162例NAFLD患者,所有入组患者按随机数字表法分为对照组和研究组。研究组患者自入选之日起采用MDT模式,多学科合作,联合制定个体化治疗方案,综合诊断和治疗NAFLD以及NAFLD相关全身系统损害;对照组患者采用NAFLD常规诊疗模式,根据肝功、血糖、血脂等情况就诊于不同科室,并给予相应药物治疗以及饮食运动指导。比较干预前、后两组患者身体成分、肝功、肾功、血糖、胰岛功能、血脂水平、血管B超和肝脏硬度改善情况。结果两组一般资料比较,差异无统计学意义(P>0.05);两组干预后肝功水平均显著低于干预前水平(P<0.05),但干预后组间比较无差异(P>0.05);研究组干预后体质量、腰围、臀围、BMI、全身脂肪含量均显著低于干预前水平(P<0.05),但干预后以上指标的组间比较无显著性差异(P>0.05);研究组干预后的血糖水平、胰岛功能、血脂水平以及动脉硬化显著优于干预前以及对照组水平(P<0.05),干预后两组肝脏硬度值较干预前无显著改善(P>0.05)。结论MDT模式可显著改善NAFLD患者血糖、血脂和动脉硬化水平,改善胰岛素抵抗和促进胰岛功能恢复,在NAFLD诊治中具有重要的临床应用价值。Objective To explore the application value of multidisciplinary cooperation model(MDT)in the diagnosis and treatment of nonalcoholic fatty liver disease(NAFLD).Methods 162 patients with NAFLD who met the inclusion criteria and were treated in the infection department of the first people’s Hospital of Kashgar from June 2019 to June 2020 were prospectively selected.All patients were randomly divided into control group and study group.Study group:all patients adopted MDT mode and multidisciplinary cooperation to jointly formulate individualized treatment plan since the date of inclusion,Comprehensive diagnosis and treatment of NAFLD and NAFLD related systemic damage;Control group:NAFLD routine diagnosis and treatment mode was adopted,and patients were treated in different departments according to liver function,blood glucose and blood lipid,and given corresponding drug treatment and diet and exercise guidance.The improvement of body composition,liver function,kidney function,blood glucose,islet function,blood lipid level,vascular B-ultrasound and liver hardness were compared between the two groups before and after intervention.Results There was no significant difference in general data between the two groups(P>0.05);The average level of liver function and water in the two groups after intervention was significantly lower than that before intervention(P<0.05),but there was no difference between the two groups after intervention(P>0.05);The body mass,waist circumference,hip circumference,BMI and body fat content of the study group after intervention were significantly lower than those before intervention(P<0.05),but there was no significant difference between the groups after intervention(P>0.05);After the intervention,the blood glucose level,islet function,blood lipid level and arteriosclerosis in the study group were significantly better than those before the intervention and the control group(P<0.05).After the intervention,the liver hardness of the two groups was not significantly improved compared with that befo

关 键 词：多学科协作模式 非酒精性脂肪性肝病 胰岛素抵抗 胰岛功能恢复 

分 类 号：R575.1[医药卫生—消化系统]