苯作业工人非酒精性脂肪肝与颈动脉粥样硬化和肝功能的关系

Relationship between nonalcoholic fatty liver disease and carotid atherosclerosis,liver function in workers exposed to benzene

目的通过超声和肝功能检测探讨苯作业工人非酒精性脂肪肝与颈动脉粥样硬化及肝功能的关系。方法选取深圳市龙岗区内215名工龄在2~18 a的苯作业工人的肝、颈动脉超声及肝功能检查结果进行分析。结果与正常肝对照组比较,中、重度非酒精性脂肪肝组颈动脉内-中膜厚度（IMT）增厚（P〈0.01）,重度组颈动脉斑块检出率增高（P〈0.01）,轻度组肝功能丙氨酸氨基转移酶（ALT）异常检出率增高（P〈0.05）,差异均有统计学意义。在非酒精性脂肪肝组颈动脉内膜增厚检出率及ALT异常检出率,中度组高于轻度组,重度组高于中度组,差异均有统计学意义（P〈0.05）。结论苯作业人群中,不同程度非酒精性脂肪肝与颈动脉粥样硬化和肝功能存在相关性。中、重度非酒精性脂肪肝工人更易发生颈动脉粥样硬化,应进行必要的预防和治疗。超声检测颈动脉IMT和肝功能可以反映苯作业人群非酒精性脂肪肝的严重程度,可辅助分级。

[Objective] By using ultrasound and liver function examination,to explore the relationship between nonalcoholic fatty liver disease and carotid atherosclerosis,liver function in workers exposed to benzene. [Methods] 215 benzene-exposed workers with working age of 2-18 years in this area received the ultrasound examination for liver and carotid artery,as well as liver function examination. The examination results were analyzed. [Results] Compared with the normal control group（healthy liver controls）,the intima-media thickness（IMT） in carotid artery in moderate and severe nonalcoholic fatty liver groups increased（P〈0.01）,the detection rate of carotid plaque in severe nonalcoholic fatty liver group increased（P〈0.01）,the abnormal rate of alanine aminotransferase（ALT） in mild nonalcoholic fatty liver group increased（P〈0.05）,and the differences were statistically significant. The detection rate of carotid plaque and the abnormal rate of ALT in moderate nonalcoholic fatty liver group were higher than those in mild nonalcoholic fatty liver group,while these indexes in severe nonalcoholic fatty liver group were higher than those in moderate nonalcoholic fatty liver group,and the differences were statistically significant（P 〈0.05）. [Conclusion]Among workers exposed to benzene,the nonalcoholic fatty liver disease is correlated with carotid atherosclerosis and liver function. The workers with moderate and severe nonalcoholic fatty liver disease are prone to suffer from carotid atherosclerosis,and it is necessary to strengthen the precaution and treatment. The ultrasound examination for carotid IMT and liver function examination can evaluate the degree of nonalcoholic fatty liver disease in workers exposed to benzene,and provide auxiliary effect in grading.