非酒精性脂肪肝病患者对健康行为干预的依从性及影响因素分析

摘要

目的 分析非酒精性脂肪肝病患者对健康行为干预的依从性及其影响因素.方法 以100例B超确诊的非酒精性脂肪肝患者为观察对象,观察健康行为干预半年后患者的基本情况、身体指标、生化指标及脂肪肝的转归情况,通过病例对照分析及logistics回归分析探讨非酒精性脂肪肝患者依从性及其影响因素.结果 被干预半年后,有78例(78.0%)完成了随访,其中依从性好组23例(29.5%),依从性差组55例(70.5%).两组间患者的体重、体重指数、腰围、甘油三酯(TG)、胆固醇(TC)、低密度非蛋白(LDL)比较差异均具有统计学意义(P<0.05).依从性好组23例NAFLD患者有10例(43.47%)转为正常,依从性差组8例(14.54%)转归为正常,差异具有统计学意义(P<0.05).单因素分析发现,年龄、BMI、工作状态、脂肪肝相关知识的知晓率和脂肪肝的分级程度为NAFLD患者依从性的影响因素.多因素logistic回归分析显示:年龄和脂肪肝的分级程度与NAFLD患者的依从性独立相关.结论 健康行为干预是脂肪肝管理的关键环节,提高非酒精性脂肪肝患者对于疾病的认知度,增强自身管理能力,制定个性化的饮食、运动方案和随访策略值得进一步探索.%Objective To analyze the compliance of health behavior intervention and its influencing factors in patients with non-alcoholic fatty liver disease. Methods 100 non-alcoholic fatty liver patients diagnosed by B ultrasound were studied. The basic condition,body indexes,biochemical indexes and the outcome of fatty liver were observed after six months of health behavior intervention. The compliance and its influencing factors of patients with non-alcoholic fatty liver disease were investigated by case-control analysis and logistic regression analysis. Results Half year after the intervention, 78 patients(78.0%)completed the follow-up,of which 23(29.5%)had good compliance and 55(70.5%)had poor compliance. The differences in body weight,body mass index,waist circumference,TG,TC,and LDL between the two groups were statistically significant(P<0.05). In the good compliance group,10(43.47%)of 23 NAFLD patients turned to normal,and 8(14.54%)of the poor compliance group turned normal. The difference was statistically significant(P<0.05). Univariate analysis showed that age,BMI,working status,awareness rate of fatty liver related knowledge and classification of fatty liver were the influencing factors of compliance in NAFLD patients. Multivariate logistic regression analysis showed that age and grade of fatty liver were independently associated with adherence in patients with NAFLD. Conclusion Healthy behavior intervention is the key link in the management of fatty liver. It is worth further exploration to improve the cognition of patients with non-alcoholic fatty liver disease, enhance their management ability and formulate personalized diet,exercise program and follow-up strategy.