非酒精性脂肪性肝病合并代谢综合征的临床研究

Clinical Investigation of Non-Alcoholic Fatty Liver Disease with Metabolic Syndrome

目的探讨非酒精性脂肪性肝病(NAFLD)合并代谢综合征(MS)的患病情况、临床特点。方法选取在我院体检中心体检诊断的NAFLD患者207例,按有无合并MS分为单纯NAFLD组114例,NAFLD合并MS组93例,比较两组患者的临床资料。结果 (1)NAFLD中合并MS的患病率为44.93%,两组患者的性别比及发病年龄无明显差异(P>0.05);(2)肝脏血清酶学指标:NAFLD合并MS组患者的ALT及AST和单纯NAFLD组相比无明显差异(P>0.05),但AST/ALT>1的发生率较单纯NAFLD组显著增多(P<0.05);(3)代谢指标:NAFLD合并MS组患者的腰围、甘油三酯、空腹血糖及血尿酸均较单纯NAFLD组明显增高(P<0.05),但是血压、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇无明显差异(P>0.05);(4)并发症:NAFLD合并MS组冠心病、糖尿病及高血压病的发生率均较单纯NAFLD组显著增多(P<0.05)。结论 NAFLD合并MS患者的肝酶(AST/ALT>1)异常及并发症发生率高,代谢异常程度严重,应给予有效的干预措施。

Objective To explore the morbidity and clinical characteristic of non-alcoholic fatty liver disease（NAFLD） with metabolic snydrome（MS）.Methods 207 patients with NAFLD were enrolled in this ssurvey.The subjects were divided into two groups：those only with NAFLD;those with both of the two diseases（NAFLD and MS）.Clinical data in the two groups were evaluated.Results The prevalence of MS was 44.93% in the all NAFLD patients,there were no difference between two groups according to ratio of malet of emale and age distribution respectively（P＆gt;0.05）.For alanine aminotransferase（ALT）and aspartate aminotransferase（AST） in the liver function,there were also no difference between two groups respectively（P＆gt;0.05）,but incidence rate of AST/ALT＆gt;1 in the patients with both of the two diseases（NAFLD and MS） was higher than that of patients only with NAFLD（P＆lt;0.05）.For metabolic parameters,waist circumference,triglyceride,fasting plasma glucose and serum uric acid were significantly increased in the group with both of the two diseases（NAFLD and MS）,compaing with those only with NAFLD（P＆lt;0.05）.However,there were no difference in both group on blood pressure,serum total cholesterol,hish density lipoprotein cholesterol and low density lipoprotein cholesterol（P＆gt;0.05）.Incidence rate of coronary heart disease,diabetes melitus and hypertension were higher in the group with both of the two diseases（NAFLD and MS）than that in only NAFLD group（P＆lt;0.05）.Conclusion The prevalence of abnormal liver function（AST/ALT＆gt;1）and complications are high in patients with both of the two diseases（NAFLD and MS）,extent of metabolic abnormality also high.Effective treatment should be taken to intervene NAFLD with MS.