非酒精性脂肪性肝病各期血清学指标变化的临床研究

Clinical research of serum parameter changes at different stages of development of NAFLD

目的探讨非酒精性脂肪性肝病(NAFLD)患者在疾病发展的不同时期血清学指标的变化规律。方法研究47例经肝活检病理诊断为NAFLD的患者(单纯性脂肪肝19例、轻度肝纤维化18例、进展性肝纤维化10例),检测天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、胰岛素抵抗(IR)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、三酰甘油(TG)、透明质酸、Ⅳ型胶原和高敏C-反应蛋白(hs-CRP),观察其变化规律。结果 3组均处于高脂状态,与单纯性脂肪肝患者相比,轻度肝纤维化患者和进展性纤维化患者各项血清学指标除HDL-C无明显差异外,各项指标均有不同程度的升高,且差异具有统计学意义;与轻度肝纤维化患者比较,进展性肝纤维化患者除HDL-C无明显变化外,其余各项指标亦有不同程度的升高,且差异具有统计学意义。结论高血脂和脂代谢紊乱与非酒精性脂肪性肝病密切相关,血清学指标升高与肝纤维化程度密切相关。

Objective To investigate the changes of serum parameters at different stages of development of th.e non-alcoholic fatty liver disease （NAFLD） in patients. Methods The concentrations of serum parameters of 47 NAFLD patients （19 of them had simple fatty liver, 18 of them had mild liver fibrosis, and 10 of them had progressive liver fibrosis） were determined,including aspartic acid amino transferase （AST）, alanine aminotransferase （ALT）, insulin resistance （IR）, high-density lipoprotein cholesterol （ HDL-C）, low-density lipoprotein cholesterol （LDL-C）, triglyeerides （TG）, hyaluronie acid, IV collagen, and high-sensitivity C-reactive protein （hs-CRP）. The changing rules of these parameters were also observed. Results Three groups were in a high-fat state. Compared with patients with simple fatty liver,the serum markers were different degree elevated in cases with mild liver fibrosis and progressive liver fibrosis （P〈0.05）,except HDLC. Compared with patients with mild liver fibrosis,the serum markers were different degree elevated in cases with progressive liver fibrosis,except HDL-C. Conclusion NAFLD was closely related to hyperlipemia and lipid metabolism disorders. Liver fibrosis degree was closely related to the concentrations of serum markers.