超声定量分析非酒精性脂肪肝肝脏脂肪含量与代谢综合征及大血管病变的关系

Quantitative analysis of the correlation between liver fatty content in nonalcoholic fatty liver and metabolic syndrome and macro-vascular disease by ultrasound

目的探讨超声定量测量非酒精性脂肪肝患者肝脏脂肪含量的应用价值,及其与代谢综合征和大血管病变的相关性。方法选取非酒精性脂肪肝患者148例,根据WHO制定的肝脏脂肪浸润程度分为轻度(50例)、中度(49例)及重度(49例)脂肪浸润组,另选无脂肪肝组49例。应用超声定量方法估测各组肝脏脂肪含量,并结合体质量指数、血压、血糖、血脂、肝功能等实验室检查结果及颈动脉斑块积分情况,比较各组间指标的差异性;分析肝脏脂肪含量与各指标的相关性。结果在校正了年龄和性别的影响后,无脂肪肝组、轻度脂肪浸润组、中度脂肪浸润组及重度脂肪浸润组除收缩压和总胆固醇外,其余指标比较差异均有统计学意义(均P<0.05)。肝脏脂肪含量与肥胖、糖尿病、脂代谢紊乱、高血压病、颈动脉斑块积分及肝功能的改变均相关。结论超声定量方法能较准确地估测肝脏脂肪含量,其与代谢综合征和颈动脉内-中膜病变相关。

Objective To investigate the correlation between liver fatty content in nonalcoholic fatty liver patients and metabolic syndrome and macro-vascular disease by ultrasound.Methods A total of 148 patients with nonalcoholic fatty liver disease were selected and divided into mild fatty infiltration group(50 cases),moderate fatty infiltration group(49 cases) and severe fatty infiltration group(49 cases) according to WHO classification of fatty liver infiltration,another 49 cases without fatty liver were selected as non-fatty liver group. Quantitative methods by ultrasound were used to estimate liver fatty content in each group,combining with body mass index,blood pressure,blood glucose,blood lipids,the results of laboratory tests such as hepatic function and carotid plaque scores to compared the differences among these groups,and the correlation between liver fatty content and all the indicators in above was analyzed.Results After adjusting for age and gender,there were significant differences among indicators except systolic blood pressure and total cholesterol in the non-fatty liver group,mild fatty infiltration group,moderate fatty infiltration group and severe fatty infiltration group(all P<0.05). Liver fatty content had significant correlation with obesity,diabetes,dyslipidemia,hypertension,carotid plaque scores and hepatic function changes.Conclusion Ultrasonic quantitative method can accurately estimate liver fatty content,and there is a certain correlation between liver fatty content and metabolic syndrome and carotid intima-media disease.