单纯性非酒精性脂肪肝与非酒精性脂肪性肝炎临床特征比较

摘要

目的 探讨单纯性非酒精性脂肪肝(NAFL)与非酒精性脂肪性肝炎(NASH)患者临床相关因素的异同点.方法 收集2006年6月～2010年6月间我院住院及门诊资料完整的非酒精性脂肪性肝病(NAFLD)患者150例,其中非酒精性脂肪性肝炎65例,非酒精性脂肪肝85例,比较两组患者年龄、体重指数(BMI)、临床表现、实验室检查和合并症等因素.结果 非酒精性脂肪性肝炎组患者BMI、血清铁蛋白、IV型胶原、空腹胰岛素、空腹血糖、胰岛素抵抗指数、代谢综合症等相关疾病的发生率较非洒精性脂肪肝组明显增多,差异有显著性(P<0.05),其余指标比较差异无显著性.结论 非酒精性脂肪肝组与非酒精性脂肪性肝炎组患者非特异性症状(如疲劳、乏力等)的发生率及肝功能比较尤显著性差异;非酒精性脂肪性肝炎组并发症(如2型糖尿病等)较非洒精性脂肪肝组突出;非酒精性脂肪性肝炎组BMI、血清铁蛋白、Ⅳ型胶原、空腹血糖、空腹胰岛素、胰岛素抵抗指数等血清学指标较非酒精性脂肪肝组显著升高.%Objective To investigate the similarities and differences between non-alcoholic fatty liver and non-alcoholic steatohepatitis, for assistance to the clinical diagnosis and treatment. Methods 150 cases of non-alcoholic fatty liver disease, who were from the first Hospital of Wenzhou Medical College from Jun. 2006 to Jun. 2010,were divided into non-alcoholic fatty liver group( 85 cases) and non-alcoholic steatohepatitis group(65 cases). Age, body mass index, clinical manifestations, laboratory findings and complications in the two groups were analysed and compared retrospectively. Results In NASH group,BMI, serum ferritin, Ⅳ collagen, Insulin resistance index ( HOWA-IR ), fasting glucose ( FPG), Fasting insulin( FINS), and the incidence of metabolic syndrome related the diseases increased significantly compared with NAFL;no difference in other parameters. Conclusions There were no difference in Liver function tests and the incidence of non-specific symptoms( such as fatigue fatigue, etc. ) between NAFL and NASH;In NASH group, complications( such as type 2 diabetes) were more prominent compared with N AFL; In NASH group, BM I, serum ferritin, Ⅳ collagen,fasting glucose,fasting insulin and insulin resistance index were significantly higher than the NAFL group.