超声检出脂肪肝与血脂水平及肝功能关系分析

Relationship of fatty liver detected by B-ultrasound with serum lipid level and hepatic function

目的探讨脂肪肝与血脂、肝功能之间关系,为其诊断及预后提供依据。方法随机抽取在我院体检超声检出86例脂肪肝者为患者组。对其匹配正常者98例为健康对照组,测定空腹静脉血中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo-B)、脂蛋白(a)[Lp(a)];肝功能检测指标:丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)。结果脂肪肝患者组TC、TG、LDL-C、Apo-B、Lp(a)、ALT、GGT浓度显著高于对照组(P<0.01),分别为TC(4.35±1.21)mmol/L vs(2.23±0.68)mmol/L,TG(5.28±0.78)mmol/L vs(4.38±0.73)mmol/L,LDL-C(4.35±1.02)mmol/L vs(3.25±0.87)mmol/L,Apo-B(1.02±0.28)mg/L vs(0.76±0.22)mg/L,Lp(a)(0.22±0.08)mg/L vs(0.13±0.06)mg/L,ALT(40±17)U/L vs(25±12)U/L,GGT(56±21)U/L vs(26±14)U/L;而HDL-C、Apo-A1低于健康对照组(P<0.01),分别为HDL-C(1.32±0.50)mmol/L vs(1.87±0.37)mmol/L,Apo-A1(1.09±0.32)g/L vs(1.35±0.43)g/L;脂肪肝患者组TC、TG、LDL-C、Apo-A1、Apo-B、Lp(a)、ALT、GGT浓度异常比例显著高于对照组,分别为TC 41.9%vs 14.3%,TG 74.4%vs 32.7%,LDL-C 55.8%vs 28.6%,Apo-A1 23.3%vs 11.2,Apo-B 27.9%vs13.3%(P<0.05或<0.01)。结论超声检查结合血脂、肝功能的异常情况对脂肪肝诊断及预后具有指导作用。

Objective To investigate the relationship between fatty liver with serum lipid level and hepatic function,providing foundations for the diagnosis and prognosis of fatty liver. Methods Randomly selected 86 cases of fatty liver detected by body check ultrasound in the hospital as the patients＇ group, 98 healthy cases in match as control group,their fasting venous blood lipid levels were detected, items including：total cholesterol（TC）, triglyceride（TG）, high density lipoprotein（ HDL-C）, low density lipoprotein（ LDL-C）, apolipoprotein Al （Apo-Al）, apolipoprotein B（Apo- B）, lipoprotein （a） （ Lp [ a ]）, indicators for hepatic function ： alanine aminotransferase （ ALT）, γ-glutamyltransferase （GGT） ,these indexes were compared with those of control group. Results Compared with those of control group, the levels of TC,TG,LDL-C,Apo-B,Lp （a）, ALT, GGT of patients＇ group were significantly higher, TC （4.35 ± 1.21 ） mmol/L vs （2.23 ± 0.68） mmol/L, TG（5.28± 0.78） mmol/L vs （4.38 ± 0.73） mmol/L, LDL-C（4.35 ± 1.02） mmol/L vs （3.25±0.87） mmol/L,Apo-B（1.02±0.28） mg/L vs （0.76±0.22） mg/L,Lp（a）（0. 22±0.08） mg/L vs （0.13±0.06） mg/L,ALT（40±17） U/L vs （25±12） U/L,GGT（56±21） U/L vs （26±14） U/L,respectively;while the levels of HDL-C,Apo-A1 were significantly lower,HDL-C（1.32±0.50） mmol/L vs （1.87±0.37） mmol/L,Apo- A1 （1.09±0.32） g/L vs （ 1.35 ± 0.43） g/L, respectively ; the abnormal concentration ratio of TC, TG, LDL-C, Apo- A1, Apo-B,Lp （a）, ALT, GGT of patients ＇ group were significantly higher, TC 41.9 % vs 14.3 %, TG 74.4 % vs 32.7%,LDL-C 55.8% vs 28.6%,Apo-Al 23.3% vs 11.2%,Apo-B 27.9% vs 13.3%（P 〈0.05 or 〈0. 01）, respectively. Conclusion Ultrasound detection combined with abnormalities of the serum lipid level and hepatic function are meaningful for diagnosis and prognosis of fatty liver.