摘要
目的:非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)合并慢性乙型肝炎病毒(hepatitis B virus,HBV)患者血清中肝功能、血脂、血糖和胰岛素水平的研究.方法:收集永康市第一人民医院2014-01/2015-12收治的NAFLD86例,其中NAFLD组39例,NAFLD合并HBV感染组37例;并选择同期健康体检者38例为正常对照组.观察3组肝功能、血脂及空腹血糖、胰岛素表达水平及胰岛素抵抗指数.结果:NAFLD组及NAFLD合并HBV感染组总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate transaminase,AST)、?-谷氨酰转肽酶(?-glutamyl transpeptidase,GGT)均高于正常对照组,且NAFLD合并HBV感染组TBIL、DBIL、ALT、AST、GGT均高于单纯NAFLD组,差异均具有统计学意义(P<0.05);NAFLD组及NAFLD合并HBV感染组低密度脂蛋白(low-density lipoprotein,LDL)、胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)均高于正常对照组,NAFLD合并HBV感染组LDL、TC、TG均高于单纯NAFLD组,差异均具有统计学意义(P<0.05);NAFLD组及NAFLD合并HBV感染组空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)均高于正常对照组,胰岛素抵抗指数胰岛素敏感指数(insulin sensitivity index,ISI)低于单纯NAFLD组,且NAFLD合并HBV感染组FPG、FINS高于单纯NAFLD组,胰岛素抵抗指数ISI低于单纯NAFLD组(P<0.05).结论:NAFLD患者感染慢性HBV后,胰岛素敏感性降低,体内代谢紊乱加重,肝脏损伤进一步加剧.
AIM： To detect the variations of liver function,serum lipids, blood glucose and insulin levels in patients with non-alcoholic fatty liver disease （NAFLD） accompanied by chronic hepatitis B （CHB）. METHODS： A total of 88 patients with fatty liver treated at our hospital from January 2014 to December 2015 were recruited in this study, which included 39 patients with NAFLD alone and 37 patients with NAFLD combined with CHB. Thirty-eight people who underwent a medical examination at our hospital during the same period were recruited as a control group. The levels of liver function indicators, serum lipids, blood glucose and insulin in the three groups were detected and compared. RESULTS： The levels of total bilirubin （TBIL）, direct bilirubin （DBIL）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST） and gamma glutamyl transpeptidase （GGT） in patients with NAFLD alone and those with NAFLD combined with CHB were significantly higher than those in the control group, and the levels of TBIL, DBIL, ALT, AST and GGT in patients with NAFLD combined with CHB were significantly higher than those in patients with NAFLD alone （P 〈 0.05）. The levels of low density lipoprotein （LDL）, cholesterol （TC） and triglyceride （TG） in patients with NAFLD alone and those with NAFLD combined with CHB were significantly higher than those in the control group, and the levels of LDL, TC and TG in patients with NAFLD combined with CHB were higher than those in patients with NAFLD alone （P 〈 0.05）. The levels of fasting insulin in patients with NAFLD alone and those with NAFLD combined with CHB were significantly higher than those in the control group （P 〈 0.05）, although there was no significant difference in the levels of fasting plasma glucose in the three groups （P 〉 0.05）. The levels of insulin sensitivity index （ISI） were significantly lower in patients with NAFLD alone and those with NAFLD combined with CHB than in the control group, and in patients with
出处
《世界华人消化杂志》
CAS
2016年第23期3523-3528,共6页
World Chinese Journal of Digestology
