非酒精性脂肪肝伴颈动脉粥样硬化患者中医证候与肝功能、血脂、血清炎症因子水平的关系

The relationship of TCM symptoms and liver function,blood lipids and serum inflammatory factor levels in patients with non-alcoholic fatty liver combined with carotid atherosclerosis

目的探讨非酒精性脂肪肝(NAFLD)伴颈动脉粥样硬化(CAS)患者中医症候与肝功能、血脂、血清炎症因子水平的关系。方法筛选NAFLD伴CAS患者60例并进行中医辨证分型,以单纯NAFLD 30例为对照组,测定血清胆红素(TBIL)、丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、甘油三酯(TG)、脂联素(APN)、高敏C反应蛋白(hs-CRP)、血白细胞(WBC)等指标进行检查,并比较血清炎症因子水平。结果不同证型NAFLD伴CAS患者TBIL、ALT、AST、TG、APN、Hs-CRP等指标均较单纯NAFLD对照组显著上升或降低(P<0.05),2组TBIL、ALT、TG比较,差异均有统计学意义(P<0.05);痰瘀互结证组Hs-CRP、APN均较脾虚痰湿证、湿热内蕴证组显著升高(P<0.05)。结论 NAFLD患者血清胆红素降低、TG升高与CAS的发生、发展关系密切,NAFLD伴CAS患病者的Hs-CRP、APN可以作为痰瘀互结证辨证论证的参考。

Objective To investigate the relationship of TCM symptoms and liver function,blood lipids and serum inflammatory factor levels in patients with non-alcoholic fatty liver combined with carotid atherosclerosis.Methods 60 patients with non-alcoholic fatty liver disease(NAFLD) combined with carotid atherosclerosis(CAS) performed syndrome differentiation type,30 patients with simple NAFLD were as controls,and serum bilirubin hormone(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglycerides(TG),adiponectin(APN),high-sensitivity C-reactive protein(hs-CRP),white blood cells(WBC) were determined and compared serum levels of inflammatory mediators.Results TBIL,ALT,AST,TG,APN and hs-CRP parameters were significantly increased or decreased in different syndromes of NAFLD with CAS patients than those in simple NAFLD control group(P<0.01 or P <0.05).There were significant differences of TBIL,ALT and TG in the two groups(P<0.05).There was significantly higher of hs-CRP and APN in phlegm and blood stasis syndrome group comparing with spleen phlegm dampness syndrome group(P<0.05).Conclusion There are close relation between decrease of serum bilirubin,increase of TG and the occurrence and development of the CAS in NAFLD patients.The hs-CRP and APN can be used as reference phlegm and blood stasis certificate dialectical argumentation in patients with NAFLD combined.