非酒精性脂肪性肝病合并原发性高血压患者临床指标分析

The analysis of clinical indexes in patients with nonalcoholic fatty liver disease combined with hypertension

目的非酒精性脂肪性肝病(NAFLD)不仅是代谢综合征的一种肝脏表现,也与2型糖尿病、血脂异常和高血压病等密切相关。针对NAFLD合并原发性高血压患者,探究其临床特征及实验指标与疾病发生的相关性。方法共纳入大连市中心医院2019年3月至2021年3月NAFLD合并原发性高血压患者134例,匹配对照组98例。对两组患者的临床基线及检验指标进行比较分析,并进行Logistic回归分析。结果试验组中丙氨酸氨基转移酶、谷氨酰转肽酶、乳酸脱氢酶、三酰甘油较对照组升高(22 U/L比17 U/L、23 U/L比17 U/L、179 U/L比173 U/L、1.680 mmol/L比1.450 mmol/L),而同型半胱氨酸、白蛋白(ALB)、肌酐、游离三碘甲腺原氨酸较对照组降低[11.2μmol/L比12.2μmol/L、41.5 g/L比43.5 g/L、54μmol/L比60μmol/L、(4.657±0.599)pmol/L比(4.850±0.574)pmol/L],差异有统计学意义(P<0.05)。多因素Logistic回归分析发现体质量指数(BMI)、糖尿病、ALB与NAFLD发生呈独立相关。结论BMI、糖尿病为原发性高血压患者发生NAFLD的独立危险因素,ALB为独立保护因素。

Objective Non-alcoholic fatty liver disease(NAFLD)is not only a liver manifestation of metabolic syndrome,but also related to type 2 diabetes,dyslipidemia and hypertension closely.This study aims to explore the correlation between clinical and experimental indexes and disease occurrence in patients with NAFLD combined with essential hypertension.Methods One hundred and thirty-four patients with NAFLD combined with essential hypertension and 98 patients in the control group were enrolled in this study from March 2019 to March 2021 in Dalian Central Hospital.The clinical baseline and test indexes of the two groups were compared and analyzed,and the logistic regression analysis was also performed.Results The mean and median values of alanine aminotransferase,γ-glutamyl transpeptidase,lactate dehydrogenase and triacylglycerol in the experimental group were higher than those in the control group:22 U/L vs.17 U/L,23 U/L vs.17 U/L,179 U/L vs.173 U/L,1.68 mmol/L vs.1.45 mmol/L,while the mean and median values of homocysteine,albumin(ALB),creatinine and free triiodothyronine were lower than that in the control group:11.2μmol/L vs.12.2μmol/L,41.5 g/L vs.43.5 g/L,54μmol/L vs.60μmol/L,(4.657±0.599)pmol/L vs.(4.850±0.574)pmol/L(P<0.05).Multivariate Logistic regression analysis showed that BMI,diabetes and ALB were independently correlated with NAFLD.Conclusions The BMI and diabetes were independent risk factors for NAFLD in patients with essential hypertension,and ALB is an independent protective factor.