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目的探讨酒精性脂肪性肝病(AFLD)与颈动脉内膜中层厚度(CIMT)的关系及其影响因素。方法从2012年1月-2013年12月在山东省泰山医院住院及查体人群中选取饮酒男性136例和无饮酒史男性11例作为研究对象进行横断面研究。将其分为:轻度AFLD组(A组)45例;中重度AFLD组(B组)58例;无脂肪肝组(C组)44例。多个样本的均数比较采用单因素方差分析,两两比较若方差齐则采用LSD检验,若方差不齐则采用Tamhane’s检验。结果 (1)B组人群CIMT明显高于C组(P=0.001)。(2)A组人群身体质量指数(BMI)明显高于C组(P=0.029)。A组和B组人群胆固醇(TC)、甘油三酯(TG)、极低密度脂蛋白(VLDL)、载脂蛋白(Apo)B和血尿酸(UA)均明显高于C组(P值均<0.05)。(3)A组人群GGT明显高于C组(P=0.001)。B组人群ALT、AST和GGT均明显高于C组(P值分别为0.023、0.003和0.000)。(4)A组和B组人群血肌酐(Cr)均明显低于C组(P值分别为0.007和0.005)。结论 AFLD可导致CIMT增厚,引起产生类代谢综合征样改变及肝肾功能异常,并且随着AFLD程度的加重,CIMT增厚更加明显,因此AFLD可用来作为预测人群发生CIMT增厚的指标。
Objective To investigate the relationship between alcoholic fatty liver disease (AFLD) and carotid artery intima-media thickness (CIMT) and its influencing factors. Methods From January 2012 to December 2013 in Shandong Province Taishan Hospital inpatient and physical examination population selected 136 cases of drinking men and 11 cases without drinking history of men as a cross-sectional study. Divided into: mild AFLD group (A group) 45 cases; moderate and severe AFLD group (B group) 58 cases; no fatty liver group (C group) 44 cases. One-way ANOVA was used to compare the mean of multiple samples, LSD test was used if the variance was the same, and Tamhane’s test was used if the variance was not consistent. Results (1) CIMT in group B was significantly higher than that in group C (P = 0.001). (2) The body mass index (BMI) in group A was significantly higher than that in group C (P = 0.029). The levels of cholesterol, triglyceride, VLDL, Apo B and UA in group A and group B were significantly higher than those in group C <0.05). (3) The GGT of group A was significantly higher than that of group C (P = 0.001). The ALT, AST and GGT in group B were significantly higher than those in group C (P = 0.023, 0.003 and 0.000, respectively). (4) Serum creatinine (Cr) in group A and group B were significantly lower than those in group C (P = 0.007 and 0.005, respectively). Conclusions AFLD can lead to thickening of CIMT, resulting in metabolic syndrome-like changes and abnormal liver and kidney function. And as the severity of AFLD increases, CIMT thickens more obviously. Therefore, AFLD can be used as a predictor of CIMT thickening in the population.