ALT、AST、UA与非酒精性脂肪肝病理的相关性研究

Relationship Between ALT,AST and UA Levels and Liver Histology in Patients with Nonalcoholic Fatty Liver Disease

目的探讨临床指标和非酒精性脂肪肝的病理的相关性。方法回顾性分析94例非酒精性脂肪肝患者的临床资料和肝组织病理资料，通过单因素分析和Logistic多元回归分析临床指标与NAFLD活动度积分（NAS）和纤维化分期的相关性。结果在单因素分析中，年龄、体重指数（bodymassindex，BMI）、谷丙转氨酶（alanine aminotransferase，ALT）、谷草转氨酶（aspartate aminotransferase，AST）、尿酸（uric acid，UA）水平在非酒精性脂肪性肝炎（non alcoholic steatohepatitis，NASH）组和非NASH组差异有统计学意义，ALT、AST、碱性磷酸酶（alkaline phosphatase，AKP）水平在S0-1组明显高于S2-4组，差异有统计学意义。Logistic多因素回归分析提示，AST、UA水平与NAS有相关性，AST水平与肝组织纤维化程度有相关性。结论AST、UA水平与NAFLD活动度积分，AST水平与肝纤维化分期独立相关。

Objective To explore the association between clinical parameters and liver histology in patients with nonalcoholic fatty liver disease （NAFLD）. Methods A total of 94 patients with NAFLD were retrospectively enrolled. Univariate analysis and logistic analysis were used to investigate the relationship between clinical parameters and NAFLD activity score （NAS） and fibrosis stage. Results Significant differences were found in alanine aminotransferase （ALT） , aspartate aminotransferase （AST） , and uric acid （UA） levels between the nonalcoholic steatohepatitis（NASH） group and without NASH group. In addition, significantly higher ALT, AST and alkaline phosphatase （AKP） levels were found in NAFLD patients with no/mild fibrosis fibrosis in comparison with significant fibrosis. There was correlation between ALT and UA levels and NAS. Furthermore, AST level was correlated with fibrosis stage. Conclusion AST and UA were independently associated with NAS and AST was independently associated with significant fibrosis in NAFLD patients.