影响酒精性脂肪肝患者颈动脉粥样硬化斑块的因素探讨

Investigation on risk factors of carotid atherosclerotic plaque in patients with alcoholic fatty liver

[目的]探讨影响酒精性脂肪肝患者颈动脉粥样硬化斑块的因素。[方法]选取经B超诊断符合酒精性脂肪肝的99例、无脂肪肝的53例患者作为研究对象。根据颈动脉斑块超声检测结果将152例患者分为无颈动脉粥样硬化斑块的酒精性脂肪肝组(A组)、有颈动脉粥样硬化斑块的酒精性脂肪肝组(B组)、既无颈动脉粥样硬化斑块亦无脂肪肝组(C组)、有颈动脉粥样硬化斑块但无脂肪肝组(D组);对各组年龄、血脂、载脂蛋白、体质指数(BMI)、血糖、尿酸(UA)及肝肾功能进行比较。[结果]B组患者年龄高于A组和C组,D组年龄高于A组;A组BMI、总胆固醇(TC)、三酰甘油(TG)和极低密度脂蛋白(VLDL)均明显高于C组,A组TG和VLDL较D组明显升高,B组TG明显高于C组和D组;A组、B组载脂蛋白B较C组明显升高;A组UA较B组、C组和D组均明显升高,B组UA较C组和D组均明显升高;B组谷丙转氨酶明显高于C组,A组谷草转氨酶、γ-谷氨酰转移酶(γ-GT)均明显高于C组和D组,B组γ-GT高于C组和D组,B组碱性磷酸酶高于A组;A组肌酐明显低于C组。[结论]酒精性脂肪肝有促进颈动脉粥样硬化斑块提早发生的倾向,可能与其引起的BMI、脂质、UA增加及肝肾功能代谢紊乱有关。

[Objective]To investigate the risk factors of carotid atherosclerotic plaque in patients with al-coholic fatty liver.[Methods]A cross-sectional study on the risk factors of carotid atherosclerotic plaque in alcoholic fatty liver was conducted in 152 cases with fatty liver confirmed by ultrasound B.The patients were divided into four groups .Group A ：carotid atherosclerotic plaque（-）alcoholic fathy liver .Group B ：carotid atherosclerotic plaque （＋ ）alcoholic fatry liver （＋ ） .Group C ：carotid atherosclerotic plaque （-） fathy liver（-） .Group D ：carotid atherosclerotic plague（＋ ）fatty liver（-） .[Results]The age in group B was older than group A and group C.The age in group D was older than that of group A.The BMI ,TC ,TG and VLDL in group A were higher than those of group C.The TG and VLDL in group A were higher ele-vated than those in group D.Compared with group C and group D ,the TG in group B was higher.The ApoB in group A and group B was significantly increased than that in group C.The UA in group A was in-creased than those in group B and group C and group D.The UA in group B was higher than those in group＆amp;nbsp;C and group D.The ALT in group B was higher than that in group C.The AST andγ-GT in group A were increased than those in group C and group D.Theγ-GT in group B was higher those in group C and group D.The ALP in group B was increased than that in group A.Comparing to group C ,the Cr in group A was lower ,there were significant differences among the groups.[Conclusions]It seems significantly earlier for the occurrence of carotid atherosclerotic plaque in patients with alcohollic fatty liver ,and may associate with the increase of BMI ,metabolism disorder of lipids ,UA ,liver and kidney function.