286例非酒精性脂肪肝患者血液生化指标和肝纤维化指标的分析

Assessment of the Clinical Significance of Serum Biochemistry and Liver Fibrosis Indexes in 286 Patients with Nonalcoholic Fatty Liver Disease

目的:探讨血液生化和肝纤维化指标在非酒精性脂肪肝患者临床诊断中的意义。方法:对符合B超诊断的286例非酒精性脂肪肝患者进行血液生化指标(TG、TC、HDL-c、LDL-c、ALT、AST、GGT、ALP)和肝纤维化指标(PCⅢ、HA、CⅣ、LN)检测,并以体检健康者作为对照。结果:非酒精性脂肪肝患者TG和TC水平均高于对照组(P<0.01),HDL-c和LDL-c与对照组相比分别呈下降和升高的趋势;重度非酒精性脂肪肝组ALT、AST和GGT明显升高(P<0.01),ALP升高不显著(P>0.05);非酒精性脂肪肝患者PCⅢ、HA、CⅣ和LN均高于健康组(P<0.05),重度组与轻、中度组之间PCⅢ、HA、CⅣ和LN差异均有显著性(P<0.01),中度脂肪肝与轻度脂肪肝之间PCⅢ、HA、CⅣ和LN差异无显著性(P>0.05)。结论:非酒性脂肪肝患者多项血液生化指标异常,重度非酒性脂肪肝患者尚存在不同程度的肝纤维化趋向。多项血液生化指标的检测可作为非酒精性脂肪肝筛查的重要依据,而肝纤维化指标的检测可进一步作为非酒精性脂肪肝病情监控和疗效评估的重要依据。

Objective To assess the clinical significance of serum biochemistry and liver fibrosis indexes in the patients with nonalcoholic fatty liver disease. Methods Biochemistry indexes, TG, TC, HDL-c, LDL c, ALT, AST, GGT and ALP,and liver fibrosis indexes, PC Ⅲ ,HA,CIV and LN,were determined in 286 patientes with nonalcoholic fatty liver disease diagnosed with B ultrasonic echography,and take 100 normal volunteer as control. Results Serum TG and TC levels in the patients with nonalcoholic fatty liver disease were much higher than those in the control. Serum HDL- c level was increased,but LDL-c level was decreased in the patients with nonalcoholic fatty liver disease. Serum ALT, AST and GGT levels in severe fatty liver cases were significantly raised and the serum ALP levels were not raised. Serum level of PCⅢ ,HA,CIV and I.N in the patients with nonalcoholic fatty liver disease were significantly higher than those of heathy subjects, the differences of PCⅢ . HA, C Ⅳ and LN between the patients with severe and moderate or mild fatty liver disease were significant. But the difference of PC Ⅲ , HA. C Ⅳ and LN between the patients with mild and moderate fatty liver disease was not significant. Conclusion Multiple biochemical indexes were abnormal in the pa tients with nonalcoholic fatty liver disease.and the patients with severe nonalcoholic fatty liver disease has a trend of liv er fibrosis. Determination of multiple biochemical indexes could provide a useful tool for Screening nonalcoholic fatty liv er disease. Moreover. the detection of Liver fibrosis indexes may be helpful in the monitoring and assessing curative effect of this disease.