摘要
目的探讨血清尿酸对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)进展期肝纤维化/肝硬化的诊断价值。方法选取2012年1月至2014年1月于中国人民武装警察部队特色医学中心治疗的140例NAFLD患者进行横断面研究。综合临床表现和病理结果将患者分为非进展期肝纤维化组(89例)和进展期肝纤维化/肝硬化组(51例)。比较两组患者性别、年龄、体质量指数(body massindex,BMI)、腰臀比、烟酒史、合并症;丙氨酸氨基转移酶(alanineaminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)、总胆红素(total bilirubin,TBil)、碱性磷酸酶(alkaline phosphatase,ALP)、甘油三酯(triglyceride,TG)、总胆固醇(totalcholesterol,TC)、高密度脂蛋白胆固醇(high-densitylipoprotein cholesterol,HDL-C)、尿素氮(urea nitrogen,BUN)、肌酐(creatinine,Cr)、尿酸(uric acid,UA)、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、HOMA-IR指数及血小板计数(platelet,PLT),行FibroScan记录受控衰减参数(controlled attenuation parameter,CAP)和肝硬度(liver stiffness measurement,LSM)值。采用Logistic多因素回归分析NAFLD患者进展期肝纤维化/肝硬化的独立危险因素。采用受试者工作特征(receiver operator characteristic,ROC)曲线评估独立危险因素诊断进展期肝纤维化/肝硬化的价值。结果进展期肝纤维化/肝硬化组与非进展期肝纤维化组患者年龄[(56.93±10.46)岁vs(41.72±13.85)岁]、BMI [(31.15±2.58)kg/m^2 vs(28.24±2.93)kg/m^2]、腰臀比(中位数:0.93vs0.90)、糖尿病比例(47.06%vs21.35%)、PLT(中位数:202.96×10^9/L vs 242.33×10^9/L)、AST [(62.41±30.58)U/L vs(47.81±29.06)U/L]、TBil(中位数:22.38μmol/L vs 15.05μmol/L)、FBG(中位数:6.91 mmol/L vs 6.48 mmol/L)、FNIS[(19.05±10.21)μU/ml vs(14.58±6.84)μU/ml]、HOMA-IR指数(中位数:5.11 vs 4.13)、UA(中位数:399.61μmol/L vs 348.86μmol/L]、CAP [(342.74±56.26
Objective To investigate the diagnostic value of serum uric acid(UA) on advanced fibrosis and cirrhosis in non-alcoholic fatty liver disease(NAFLD). Methods A total of 140 patients with NAFLD in Characteristic Medical Center of the Chinese People’s Armed Police Force from January 2012 to January 2014 were enrolled in this cross-sectional study. According to the clinical comprehensive performance and pathological results, the patients were divided into non-advanced fibrosis group(89 cases) and advanced fibrosis/liver cirrhosis group(51 cases), the gender, age, body mass index(BMI), waist-to-hip ratio, history of tobacco and alcohol, comorbidities;alanine aminotransferase(ALT), aspartate aminotransferase(AST), albumin(ALB), total bilirubin(TBil), alkaline phosphatase(ALP), triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), urea nitrogen(BUN), creatinine(Cr), uric acid(UA), fasting blood glucose(FBG), fasting insulin(FINS), HOMA-IR index;platelet count(PLT) of patients in two group were compared. Logistic multivariate regression analysis was used to analyzed the independent risk factors for NAFLD advanced liver fibrosis/cirrhosis. The area under the receiver operating characterstic(ROC) curve was used to evaluate the diagnostic value of meaningful indicators. Results Age [(56.93 ± 10.46) years vs(41.72 ± 13.85) years], BMI [(31.15 ± 2.58) kg/m^2 vs(28.24 ± 2.93) kg/m^2], waist-to-hip ratio(median: 0.93 vs 0.90), proportion of diabetes(47.06% vs 21.35%), PLT(median: 202.96 × 10^9/L vs 242.33 × 10^9/L), AST [(62.41 ± 30.58) U/L vs(47.81 ± 29.06) U/L], TBil(median:22.38 μmol/L vs 15.05 μmol/L), FBG(median: 6.91 mmol/L vs 6.48 mmol/L], FNIS [(19.05 ± 10.21) μU/ml vs(14.58 ± 6.84) μU/ml], HOMA-IR index(median: 5.11 vs 4.13), UA(median: 399.61 μmol/L vs 348.86 μmol/L), CAP [(342.74 ± 56.26) dB/m vs(323.58 ± 64.47) dB/m] and LSM(median: 12.00 kPa vs 7.40 kPa) of patients in advanced fibrosis/liver cirrhosis group and non-advanced fibrosis group were statistically signi
作者
刘沁雨
常越
张青
丁玉平
李海
Liu Qinyu;Chang Yue;Zhang Qing;Ding Yuping;Li Hai(Department of Hepatopancreatobiliary and Splenic Medicine,Characteristic medical center of the Chinese people’s Armed Police Force,Tianjin 300162,China;Unit 94804 of the People’s Liberation Army,Shanghai 200434,China;Division of Gastroenterology and Hepatology,Tianjin Xiqing Hospital,Tianjin 300385,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2020年第1期24-30,共7页
Chinese Journal of Liver Diseases：Electronic Version
基金
天津市救援医学临床医学研究中心课题(15ZXLCSY0040)。
关键词
脂肪性肝病
非酒精性
进展期肝纤维化
肝硬化
血清尿酸
诊断价值
Fatty liver disease,non-alcoholic
Advanced fibrosis
Liver cirrhosis
Serum uric acid
Diagnostic value
