行为干预对非酒精性脂肪肝患者的效果分析

Efficacy analysis of behavior intervention for non alcoholic fatty liver disease

目的探讨行为干预对非酒精性脂肪肝患者的有效性与可行性，评价其临床价值。方法将临床确诊的130例非酒精性脂肪肝患者进行为期6个月的行为干预，给予健康指导，半年后随访患者的体质量指数（BMI）、腰围、超声图像及血糖、血脂的变化，观察行为干预的效果。结果行为干预前患者的饮食控制合格率为8．4％，干预后为91．5％，差异有统计学意义（P〈0．01）；干预前患者的运动达标率为10．7％，干预后为89．2％，差异有统计学意义（P〈0．01）。行为干预后45例轻度脂肪肝患者中有30例脂肪肝消失，转归正常；56例中度脂肪肝患者中有32例转为轻度脂肪肝，4例脂肪肝消失，转归正常；29例重度脂肪肝患者中有16例转为中度脂肪肝，2例转为轻度脂肪肝，差异均有统计学意义（P〈0．01）。超声观察结果显示，行为干预后肝左叶厚度、肝右叶最大斜径较干预前显著降低，差异均有统计学意义（P〈0．01）。行为干预后患者的体质量指数、腰围较干预前显著降低（P〈0．01），差异均有统计学意义。行为干预后患者的血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇均较干预前降低，差异均有统计学意义（P〈0．05）。结论行为干预能帮助患者建立健康的生活方式，有助于机体血糖、血脂、BMI等的稳定，降低脂肪肝发病率，提高脂肪肝的逆转率。

Objective To investigate the effectiveness and feasibility of behavior intervention in patients with non alcoholic fatty liver disease （NAFLD） and analyze its clinical value. Methods The 130 patients with NAFLD were given behavior intervention and health education for 6 months, then the changes in the patients of BMI, waist circumference, ultrasound images and blood glucose, blood lipids and the effect of behavior intervention were observed. Results After behavior in- tervention, the food control qualified rate increased from 8.4% to 91.5%, the exercise compliance rate increased from 10.7% to 89.2% , the differences were statistically significant （P 〈0.01 ）. After intervention, 30 mild fatty liver patients recovered to normal （P 〈 0.01 ） ; while among moderate eases, 32 turned into mild and 4 recovered to normal （P 〈0.01 ） ; among severe cases, 16 turned into moderate and 2 turned into mild （P 〈 0.01 ）. The left liver lobe thickness and the largest oblique di- ameter of right liver lobe decreased compared with pre- intervention, the difference was statistically sig- nificant （P 〈 0.01 ）. The levels of BMI, waist circumference significantly reduced after behavior in- tervention （P 〈 0.01 ）. The levels of Bs, CH and LDL-C were significantly reduced after behavior intervention （P 〈 0. 05 ）. Conclusions Behavior intervention can help NAFLD patients establish healthy lifestyle, stabilize the levels of blood glucose, blood lipids and BMI, and effectively reduce the morbidity, increase the recovery rate in NAFLD patients.