非酒精性脂肪肝与血脂及血常规指标的相关性

Correlation of non-alcoholic fatty liver with blood lipids and blood routine indicators

目的 探讨非酒精性脂肪肝(NAFLD)与血脂及血常规指标的相关性,为临床诊治NAFLD提供量化指标。方法 收集2017年11月至2018年1月本院住院患者中159例NAFLD患者作为观察组,选取同期住院的69例无脂肪肝的患者作为对照组,所有受试对象均采集空腹静脉血,比较两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白(NonHDL-C)、血红蛋白、红细胞计数。结果 观察组除高密度载酯蛋低于对照组,其他血脂5项和血象2项指标均高于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果提示,模型差异有统计学意义(χ^2=60.351,P<0.001),模型诊断符合率为80.9%,进入方程中的指标有TG、血红蛋白,这两项指标与NAFLD呈正相关关系,TG水平越高患脂肪肝的可能性越大;观察组TG比对照组高出5倍(OR=5.03,95%CI2.63-9.64);血红蛋白高也是NAFLD患者的影响因素,但其危险性比TG小得多,仅1倍(OR=1.03,95%CI1.01-1.05)。结论 NAFLD患者血脂5项与血常规2项均存在差异,NAFLD与TG呈正相关关系,尤其是TG,故TG和血红蛋白均可作为临床防治NAFLD的量化指标。

Objective To study the correlation of non-alcoholic fatty liver(NAFLD)with blood lipids and blood routine indicators and to provide quantitative indicators for clinical diagnosis and treatment of NAFLD.Methods 159 patients with NAFLD treated at our hospital from November,2017 to January,2018 were collected as an observation group,and 69 patients without NAFLD treated at our hospital during the same period a control group.Fasting venous blood was collected from all subjects.The total cholesterol(TC),triglyceride(TG),LDL-C,HDL-C,non-HDL-C,red blood cell count,and hemoglobin were compared between the 2 groups.Results The HDL-C was lower and the TC,TG,LDL-C,non-HDL-C,red blood cell count,and hemoglobin were higher in the observation group than in the control group(all P<0.05).Multiple factor logistic regression analysis suggested that the diagnostic coincidence rate of the model was 80.9%;triglyceride and hemoglobin positively correlated with NAFLD;the higher the triglyceride level,the greater the possibility of fatty liver;the triglyceride level of the NAFLD patients was five times as high as that of the control group(OR=5.03,95%CI:2.63-9.64);high hemoglobin was also a risk factor for the NAFLD patients,and the risk was much less than that of triglycerides,only 1-fold(OR=1.03,95%CI:1.01-1.05).Conclusion There are differences in blood lipids and two blood routine indicators in patients with fatty liver.NAFLD positively correlates with triglycerides.Triglycerides and hemoglobin can be used as quantitative indicators for clinical control of NAFLD.