血脂及炎症指标在非酒精性脂肪肝合并颈动脉粥样硬化患者中的改变

The changes of serum lipid and inflammation markers in non-alcoholic fatty liver disease patients combined with atherosclerosis

目的检测并明确血脂及炎症指标在非酒精性脂肪肝合并颈动脉粥样硬化患者中的改变,以期为临床诊疗提供参考。方法分析2015年1月至2017年1月在湖北医药学院附属襄阳市第一人民医院接受诊疗的非酒精性脂肪肝患者的临床资料。依据患者是否合并颈动脉粥样硬化分为观察组(合并)及对照组(不合并)。共纳入观察组46例,对照组50例。检测两组血脂及血液炎症指标水平,并分析与颈动脉内膜中层厚度(IMT)的相关性。结果观察组患者HDL-C显著低于对照组(P<0.05),而LDL-C显著高于对照组(P<0.05)。两组患者TG及TC水平比较差异无统计学意义(P>0.05)。观察组患者外周血IL-6水平均显著高于对照组(P<0.05)。两组患者外周血IL-10及TGF-β水平比较差异无统计学意义(P>0.05)。观察组患者IMT平均值为(1.39±0.25)mm。观察组患者IMT与LDL-C(r=0.631,P<0.05)及IL-6(r=0.518,P<0.05)水平均呈显著正相关,而与HDL-C(r=-0.690,P<0.05)水平呈显著负相关。结论伴有动脉粥样硬化的非酒精性脂肪肝患者脂质代谢紊乱及系统性慢性炎症反应程度更大,且与患者颈动脉粥样硬化程度相关。

Objective To analyze the changes of serum lipid and inflammation markers in non-alcoholic fatty liver disease （NAFLD） patients combined with atherosclerosis. Methods Clinical data of NAFLD patients received treatment in hospital from 2015 to 2017 were analyzed. Patients were divided into two groups by whether sufferred from atherosclerosis. Results A total of 96 patients were collected, including group A （combined with atherosclerosis, n = 46） and group B （ not combined with atherosclerosis, n = 50）. Levels of IL-6 and LDL-C were higher and the level of HDL-C was lower in group A compared with group B, the difference was statistically significant （P 〈 0.05）. There was no sig- nificant difference in IL-10, TG, TC and TGF-β between two groups （P 〉 0.05）. Correlation analysis showed that the level of intimal medial thickness in group A had significant positive correlation with LDL-C （ r = 0.631, P 〈 0.05 ） , IL- 6 （r=0. 518,P〈0.05） and negative correlation with HDL-C （r = -0.690, P 〈0.05）. Conclusion NAFLD patients combined with atheroselerosis have more severe lipid metabolism disorders and systemic inflammatory response, they are associated with degree of atherosclerosis.