非酒精性脂肪性肝病痰瘀互结证与肌少症相关性研究

Study on correlativity between syndrome of intermingled phlegm and blood stasis and sarcopenia of non-alcoholic fatty liver disease

目的:观察痰瘀互结型非酒精性脂肪性肝病(NAFLD)患者的人体成分特点与肌少症的相关性。方法:针对69例NAFLD患者回顾性资料,采用统计学软件分析其中痰瘀互结组34例与非痰瘀互结组35例患者的人体成分指数差异,并筛选与肌少症分布有关的人体成分指标,进一步分析肌少症的相关因素。结果:痰瘀互结组患者的WHR、PBF、SMI、ICW、ECW水平均高于非痰瘀互结组(P<0.05)。筛选与肌少症分布有关的人体成分指数,显示肌少症患者的年龄显著大于非肌少症患者(P<0.05),而BMI、BMR、ICW、ECW水平均显著低于非肌少症患者(P<0.05);进一步采取二分类Logistic回归分析,显示痰瘀互结组与肌少症之间具有显著相关性(P<0.05)。结论:痰瘀互结型NAFLD患者表现为更明显的脂肪含量过载及异位蓄积,骨骼肌质量、机体水分、基础代谢率显著降低,并与肌少症相关,与痰瘀互结状态下重度气化失调、精微失布、组织失荣有洽和之处。人体成分指标,尤其与肌少症分布有关的人体成分指标对NAFLD的疗效评估有一定临床价值。

Objective:To study the correlativity between characteristics of human body composition and sarcopenia of patients with nonalcoholic fatty liver disease(NAFLD)with syndrome of intermingled phlegm and blood stasis.Methods:For the retrospective data of 69 NAFLD patients,the difference of human body composition indexes between 34 patients in phlegm and blood stasis intermingling group and 35 patients in non phlegm and blood stasis intermingling group was analyzed by statistical software,and the human body composition indexes which were related to distribution of sarcopenia were screened,and the relevant factors of sarcopenia were further analyzed.Results:The levels of WHR,PBF,SMI,ICW and ECW of NAFLD patients in phlegm and blood stasis intermingling group were higher than those in non phlegm and blood stasis intermingling group(P<0.05).To screen the human body composition indexes which were related to distribution of sarcopenia showed that the age of patients with sarcopenia was significantly higher than that of patients without sarcopenia(P < 0.05),while the levels of BMI,BMR,ICW and ECW of patients with sarcopenia were significantly lower than those of patients without sarcopenia(P < 0.05).The further binary Logistic regression analysis showed that there was a significant correlativity between phlegm and blood stasis intermingling group and sarcopenia(P < 0.05).Conclusion:NAFLD patients with syndrome of intermingled phlegm and blood stasis are characterized by more obvious overload and ectopic accumulation of fat content.The skeletal muscle mass,body water content and basal metabolic rate are significantly reduced,which is related to sarcopenia,and consistent with severe gasification disorder,fine loss of distribution and tissue loss of activity under the state of intermingled phlegm and blood stasis.Human body composition indexes,especially human body composition indexes which are related to the distribution of sarcopenia,have certain clinical value for evaluation of efficacy on NAFLD.