不同程度瘦型非酒精性脂肪性肝病患者临床指标特点及相关性分析  

Characteristics and correlation analysis of clinical indexes in patients with different degrees of lean non-alcoholic fatty liver disease

作　　者：孙沛祺 袁乙富 沈红权 刘沁毅 蒋元烨 SUN Pei-qi;YUAN Yi-fu;SHEN Hong-quan;LIU Qin-yi;JIANG Yuan-ye(Department of Gastroenterology,Shanghai Putuo Central Hospital,Shanghai 200062,China;Department of Chinese Traditional Medicine,Shanghai Putuo Central Hospital,Shanghai 200062,China;Department of Infectious diseases,Shanghai Putuo Central Hospital,Shanghai 200062,China)

机构地区：[1]普陀区中心医院,上海200062 [2]普陀区中心医院中医科,上海200062 [3]普陀区中心医院感染科,上海200062

出　　处：《肝脏》2025年第1期83-86,90,共5页Chinese Hepatology

基　　金：国家自然科学基金(82474378);上海市自然科学基金(22ZR1455900);上海市普陀区卫生健康系统科技创新项目重点项目(ptkwws202201);上海市普陀区杏林优青人才培养计划(ptxlyq2201);上海市普陀区卫生健康系统特色专病建设项目(2023tszb01)。

摘　　要：目的探寻不同程度B超的瘦型非酒精性脂肪性肝病(NAFLD)患者的临床指标之间的差异。方法选择2019年12月至2022年12月在上海市普陀区中心医院就诊的瘦型NAFLD患者336例。根据肝脏超声分级诊断标准将患者分成轻度组119例,中度组190例,重度组27例。收集患者的临床实验室数据,包括B超、血常规、肝肾功能、血脂、肿瘤指标等,并进行相关性分析。结果轻度和中度瘦型NALFD患者HCT(P=0.017)、RDW(P=0.01)、BASO(P=0.026)、AKP(P=0.002)、γ-GT(P<0.001)、ALT(P<0.001)、AST(P<0.001)、FPG(P<0.001)、LDL-C(P=0.006)、TC(P=0.006)、TG(P<0.001)、APOB(P<0.001)、CEA(P=0.002)、AFP(P<0.001)、CA211(P=0.017)、NSE(P=0.004)差异有统计学意义。瘦型NALFD患者B超严重程度与RDW(r=0.159,P=0.004)、BASO(r=0.141,P=0.01)、AKP(r=0.145,P=0.008)、γ-GT(r=0.194,P<0.001)、ALT(r=0.236,P<0.001)、AST(r=0.215,P<0.001)、FPG(r=0.202,P<0.001)、LDL-C(r=0.149,P=0.006)、TC(r=0.158,P=0.004)、TG(r=0.202,P<0.001)、APOB(r=0.169,P=0.002)、CEA(r=0.125,P=0.022)、AFP(r=0.209,P=0.001)、CA211(r=0.152,P=0.005)、NSE(r=0.169,P=0.002)等指标均呈正相关。其余指标的关联性差异无统计学意义(P>0.05)。结论与轻度瘦型NALFD患者比,中度瘦型NAFLD患者的实验室指标升高,这些实验检查结果结合B超分级可以作为诊断瘦型NAFLD严重程度的辅助依据。Objective To analyze the characteristics of clinical indexes of leannon-alcoholic fatty liver disease(NAFLD)patients with different degrees of B-ultrasound,and to explore the differences among their clinical indicators.Methods From December 2019 to December 2022,336 patients with lean NAFLD were selected from the outpatient department,inpatient department,and physical examination center of the Department of Gastroenterology in Putuo District Central Hospital,Shanghai.The patients were divided into mild group(n=119),moderate group(n=190)and severe group(n=27)according to the results of B-ultrasound and liver ultrasound grading diagnostic criteria.At the same time,we collect the clinical laboratory data of each patient,including B-ultrasound,blood routine,liver and kidney function,blood lipids,tumor indicators and other common clinical data for analysis.SPSS statistical software(version 26.0)was used to analyze the correlation of these indicators.Results There were significant differences in the distribution of HCT(P=0.017),RDW(P=0.01),BASO(P=0.026),AKP(P=0.002),γ-GT(P<0.001),ALT(P<0.001),AST(P<0.001),FPG(P<0.001),LDL-C(P=0.006),TC(P=0.006),TG(P<0.001),APOB(P<0.001),CEA(P=0.002),AFP(P<0.001),CA211(P=0.017),and NSE(P=0.004)in NALFD patients with different degrees of B-ultrasound,and the differences were only statistically significant in mild and moderate groups.The distribution of other indicators was not statistically significant(P>0.05).There was a significant correlation between the severity of B-ultrasound and RDW(r=0.159,P=0.004)、BASO(r=0.141,P=0.01)、AKP(r=0.145,P=0.008)、γ-GT(r=0.194,P<0.001)、ALT(r=0.236,P<0.001)、AST(r=0.215,P<0.001)、FPG(r=0.202,P<0.001)、LDL-C(r=0.149,P=0.006)、TC(r=0.158,P=0.004)、TG(r=0.202,P<0.001)、APOB(r=0.169,P=0.002)、CEA(r=0.125,P=0.022)、AFP(r=0.209,P=0.001)、CA211(r=0.152,P=0.005)and NSE(r=0.169,P=0.002)in patients with lean NALFD.The correlation of other indexes was not statistically significant(P>0.05).Conclusion Compared with mild lean NALFD patients,the labor

关 键 词：瘦型NAFLD B超分级 临床特点 

分 类 号：R575.5[医药卫生—消化系统]