摘要
目的 探讨非酒精性脂肪性肝炎的临床特点,为早期诊断提供依据.方法 收集200例非酒精性脂肪性肝病患者,并按照临床分型标准分为单纯性脂肪肝组115例和脂肪性肝炎组85例,对其年龄、性别、体质量指数、血压、消化道症状、伴随疾病、血生化和影像学检查进行统计分析,分析组间差异.结果 脂肪性肝炎组最常见的消化道症状为乏力,占40％,其次为腹胀、纳差、恶心呕吐、肝区隐痛和肝肿大,两组无症状患者发生率均较高（44.7％比49.2％％,P＞0.05）,与单纯性脂肪肝组比较差异均无统计学意义（均P＞0.05）;脂肪性肝炎组伴随肥胖、2型糖尿病、高血压等疾病的发生率与单纯性脂肪肝组比较差异均有统计学意义（分别为45.9％比20.0％,41.2％比22.3％,28.2％比15.6％,均P＜0.05）;脂肪性肝炎组在体质量指数、空腹血糖、餐后2h血糖、血清铁蛋白、透明质酸、Ⅳ型胶原、胰岛素抵抗指数较单纯性脂肪肝组明显升高,差异有统计学意义[分别为（28.68 ±0.92）比（22.21±0.43）,（9.63±0.64） mmol/L比（4.92±0.78） mmol/L,（12.96 ±0.28） mmol/L比（7.04±0.13） mmol/L,（243.56±7.95） ng/mL比（140.03±6.80）ng/mL,（130.26±9.16） ng/mL比（74.85±6.54） ng/mL,（130.56±8.16）ng/mL比（72.68±7.24） ng/mL,（5.36 ±0.45）比（2.63 ±0.12）,均P＜0.05].结论 非酒精性脂肪性肝炎消化道症状无特异性,多伴有肥胖、2型糖尿病、高血压等代谢综合征,同时可能存在多种代谢异常.
Objective To investigate the clinical characteristics in nonalcoholic steatohepatitis （NASH）,to provide the basis for the early clinical diagnosis.Methods 200 cases of non-alcoholic fatty liver disease（NAFLD） were divided into NAFL group（115 cases） and NASH group（85 cases）.Age,gender,body mass index,blood pressure,clinical symptoms,accompany illnesses,biochemical and image index in the two groups were analyzed and compared retrospectively.Results Asthenia,accounted for 40%,which was the most common gastrointestinal symptom of NASH group.and abdominal distension,anorexia,nausea and vomiting,liver area pain and liver were all involved.There were no significant differences in mainly gastrointestinal symptoms between patients with NASH and NAFL group（P 〉 0.05）,but no symptoms incidence of the two group were higher （44.7% vs 49.2% % P 〉 0.05） ;the incidence of obesity,hyperlipidemia,type 2 diabetes,hypertension in NASH group were significantly different compared with NAFL（45.9% vs 20%,41.2% vs 22.3%,28.2% vs 15.6% respectively P 〈 0.05） ; In NASH group,BMI,fasting glucose（FPG）,2hPPG,serum ferritin,hyaluronic acid,Ⅳ collageninsulin resistance index （HOWA-IR）increased significantly compared with NAFL[（28.68 ± 0.92）vs （22.21 ± 0.43）,（9.63 ± 0.64）mmol/L vs （4.92 ± 0.78）mmol/L,（12.96 ±0.28） mmol/L vs （7.04 ±0.13） mmol/L,（243.56 ±7.95） ng/mL vs （140.03 ± 6.80）ng/mL,（130.26 ±9.i6）ng/mL vs （74.85 ±6.54）ng/mL,（130.56 ±8.16）ng/mL vs （72.68 ±7.24） ng/mL,（5.36±0.45） vs （2.63 ±0.12）,respectively P〈0.05）].Conclusion Patients with NASH had no obvious gastroenterology symptoms.Obesity,type 2 diabetes,hypertension are more with NASH,and there may be multiple metabolic disorders.
出处
《中国基层医药》
CAS
2015年第1期45-48,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省医学科研项目（A2010632）
