基于电子化管理生活方式干预对老年非酒精性脂肪性肝病治疗的研究

Lifestyle Intervention Based on Electronic Management in Non-alcoholic Fatty Liver Disease in the Elderly

目的通过对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)老年患者生活方式干预随访,了解传统健康教育和电子化管理干预生活方式对NAFLD的影响及疾病转归。方法选择2016年4月—2017年1月于复旦大学附属华东医院脂肪肝病专病门诊及健康体检中心确诊为NAFLD的65周岁及以上老年患者90例,随机分为对照组(传统健康教育干预组)和试验组(电子化管理干预组),通过Fibroscan/CAP检查比较2组干预3个月后肝脏脂肪变程度、其他代谢和肝脏相关指标的变化情况。结果 81例患者最终纳入研究中。试验组患者经FibroScan/CAP诊断的肝脏脂肪变均有不同程度好转,与对照组比较有统计学意义(P=0.017)。试验组的体重、腹围、BMI和ALT较干预前好转,而对照组几乎没有变化。结论通过电子化设备干预,很大程度上增加了患者的依从性,能够在更大规模的人群中进行推广,取得可观的疗效。

Objective To investigate the effects of traditional health education and intervention lifestyle based on electronic management on non-alcoholic fatty liver disease（NAPLD） and the prognosis. Methods 90 elderly ≥ 65 years with the confirmed diagnosis of NAFLD in Huadong Hospital Affiliated to Fudan University during the period from April, 2016 to January,2017 were selected and randomly divided into 2 groups： control group（intervention by traditional health education） and experiment group（intervention based on electronic management）; the changes of liver steatosis and the changes of metabolic and liver-related indicators 3 months after the interventions were detected by FibroScan/CAP and a comparison was made between the 2 groups. Results In total, 81 elderly were finally enrolled; FibroScan/CAP examination indicated that the improvement of liver steatosis of the elderly in experiment group was at certain degrees, statistically different from that in control group（P=0.017）;the changes of body weight, abdominal circumference, body mass index（BMI） and serum alanine aminotransferase（ALT）in the elderly in experiment group after intervention were much more improved than those before intervention while no changes were found in the elderly in control group. Conclusions Lifestyle intervention based on electronic management can greatly increase the compliance of the elderly and is worthy of wider application.