军事潜水员非酒精性脂肪肝患病情况分析及其相关危险因素研究

Prevalence and risk factors of nonalcoholic fatty liver disease in military divers

目的 分析军事潜水员非酒精性脂肪肝患病情况及其相关危险因素,提供早期预防依据,从而降低潜水员非酒精性脂肪肝的患病率,提高健康水平,保证其战斗力。方法 收集2008-2016年在杭州某疗养院疗养与体检的1 598例军事潜水员健康档案,采集其疗养期间B超检查、生化指标及血压测量数据,采用SPSS 21.0数据软件对以上数据进行统计分析。结果军事潜水员非酒精脂肪肝患病率为16.33%,随着服役年限的增加非酒精性脂肪肝的患病率上升,差异有统计学意义(χ^2=102.117,P<0.05)。对潜水员患非酒精性脂肪肝组与正常组各代谢相关指标均值分析结果显示,患病组空腹血糖、尿酸、胆固醇、三酰甘油、低密度脂蛋白、收缩压、舒张压均值均明显高于正常组,高密度脂蛋白明显低于正常组,差异有统计学意义(t值分别为-3.999、-7.658、-5.308、-10.167、9.245、-5.41、-5.014、-6.298,均P<0.05)。代谢指标与非酒精性脂肪肝的影响因素分析显示,空腹血糖、尿酸、胆固醇、三酰甘油为非酒精性脂肪肝的危险因素,危险因素用相对危险度的精确估计值(oddratio) OR表示(OR值分别为2.619、2.042、2.271、3.534,均P<0.05)。高密度脂蛋白为非酒精性脂肪肝的保护因素(OR=0.361,P<0.05)。结论非酒精性脂肪肝患病率随着潜水员服役年限的增加上升显著,积极控制空腹血糖、尿酸、胆固醇、三酰甘油的指标可有效控制军事潜水员非酒精性脂肪肝的患病率,推迟非酒精性脂肪肝的发生,从而提高该群体的健康水平。

Objective To analyze the prevalence and risk factors of nonalcoholic fatty liver disease in military divers,so as to provide evidence for early prevention of nonalcoholic fatty liver and ultimately reduce the morbidity of nonalcoholic fatty liver disease,promote health and enhance combat effectiveness.Methods The medical data of 1598 military divers who received convalescent care and health check during stay in the sanatorium from 2008 to 2016 were recruited and ultrasonographic,biochemical and blood pressure indexes were collected for study.The obtained data were statistically analyzed by using SPSS 21.0 software.Results The morbidity of nonalcoholic fatty liver disease was 16.33%among military divers and elevated with the prolonging of service.Statistical significance could be seen,when comparisons were made(χ^2=102.117,P<0.05).Mean value analysis of metabolic indexes performed respec?tively in the nonalcoholic fatty liver group and the normal group indicated that the mean values of fasting blood glucose,uric acid,cho?lesterol,triglyceride,low density lipoprotein,systolic and diastolic blood pressure of the former group were significantly higher than those of the latter group.High density lipoprotein of the nonalcoholic fatty liver group was significantly lower than that of the normal group,with statistical significance(t=-3.999,t=-7.658,t=-5.308,t=-10.167,t=9.245,t=-5.41,t=-5.014,t=-6.298)(P<0.05).Analysis of metabolic factors and influencing factors of nonalcoholic fatty liver showed that fasting blood glu?cose,uric acid,cholesterol and triglyceride were chief risk factors of nonalcoholic fatty liver disease.Risk factors were expressed by the odd ratio(OR)of accurate estimation value.Conclusion The prevalence of nonalcoholic fatty liver disease increased significantly with the increase in the years of service.Aggressive control of fasting blood glucose,uric acid,cholesterol and triglyceride could effectively reduce the incidence of nonalcoholic fatty liver disease in military divers and help to delay onset of non?alcoholic fatty liver disease,thereby improving the health level of military divers.