中老年非酒精性脂肪肝患者临床特点及其与血脂、血尿酸水平的相关性分析

摘要

Objective To investigate the clinical characteristics of the middle and old aged patients ’ non-alcoholic fatty liver disease (NAFLD) and its correlation with the blood lipid, serum uric acid level.Methods From May 2012 to March 2014, according to the ultrasound results , 120 cases of NAFLD patients (NAFLD group) and 80 cases of healthy phys-ical examinees (healthy control group) were enrolled.Observed the clinical characteristics of patients with NAFLD , serum lipid and uric acid levels were measured in both of the 2 groups.The correlation between blood lipid , blood uric acid and NAFLD was analyzed using the multi factor Logistic regression analysis .Results In the NAFLD group, the FPG, HbA1c, TC, TG, LDL-C, UA, ALT, AST and CRP levels, and coronary heart disease , hypertension, diabetes incidence were signifi-cantly increased than the healthy control group ( P <0.05).Compared with patients only with NAFLD , when the NAFLD pa-tients complicated with hyperlipidemia , hyperuricemia , liver function decreased significantly , the incidence of coronary artery disease and diabetes rate were increased significantly ( P <0.05).Nonalcoholic fatty liver disease in elderly patients mainly were mild to moderate degree, accounting for about 94.17%;fasting blood glucose (OR=1.762, 95%CI 1.024-2.005), total cholesterol (OR=1.963, 95%CI 1.156-2.415), triacylglycerol (OR=1.876,95%CI 1.067 -2.377), low density lipoprotein (OR=2.122, 95%CI 1.243-3.003), blood uric acid (OR=1.343, 95%CI 1.013-1.528), coronary heart disease (OR=2.874, 95%CI 1.308-4.972) and diabetes (OR=2.542, 95%CI 1.179-3.672) were risk factors of non-alcoholic fatty liver, they were positively correlated with the disease ( P <0.05).Conclusion Elderly patients with non-al-coholic fatty liver disease are mainly mild to moderate degree lesions , the genesis and development is closely related to blood lipid and blood uric acid level .%目的：探讨中老年非酒精性脂肪肝（NAFLD）患者临床特点及其与血脂、血尿酸水平的相关性。方法选择2012年5月-2014年3月经超声诊断为NAFLD患者120例（ NAFLD组）及同期体检的健康者80例（健康对照组）。观察NAFLD患者的临床特征，并分别测定2组人群的血脂及血尿酸水平。采用多因素Logistic回归分析血脂、血尿酸与NAFLD的相关性。结果 NAFLD组FPG、HbA1c、TC、TG、LDL-C、UA、ALT、AST及CRP 水平，冠心病、高血压、糖尿病发病率均较健康对照组明显升高（ P ＜0缮．05）。与单纯NAFLD患者比较，当NAFLD患者合并高脂血脂、高尿酸血症时，肝功能出现显著下降，冠心病及糖尿病发生率明显增加（ P均＜0．05）。中老年患者非酒精性肝病以轻中度为主，约占94．17％；空腹血糖（OR＝1．762，95％CI 1．024～2．005）、总胆固醇（OR＝1．963，95％CI 1．156～2．415）、三酰甘油（OR＝1．876，95％CI 1．067～2．377）、低密度脂蛋白（OR＝2．122，95％CI 1．243～3．003）、血尿酸（OR＝1．343，95％CI 1．013～1．528）、冠心病（OR＝2．874，95％CI 1．308～4．972）及糖尿病（OR＝2．542，95％CI 1．179～3．672）是非酒精性脂肪肝的危险因素，均呈正相关（ P均＜0．05）。结论老年非酒精性脂肪肝患者主要为轻中度病变，其发生发展与血脂及血尿酸水平密切相关。