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目的探讨非酒精性脂肪性肝病(NAFLD)合并代谢综合征(MS)的临床特点,为其临床预防和治疗提供理论依据。方法选取2010年4月至2012年5月于开封市中心医院就诊的NAFLD患者264例,根据是否患有MS分组,分别为观察组(NAFLD合并MS)和对照组(单纯NAFLD),对比分析两组患者的肝脏酶学指标、代谢指标及并发症发生情况。结果 NAFLD合并MS的发生率为46.97%,且其发生尚不能认为与年龄、性别有关;对于肝脏血清酶学指标而言,观察组患者的丙氨酸氨基转移酶(ALT)及天门冬氨酸氨基转移酶(AST)水平与对照组比较未见统计学意义(P>0.05),但AST/ALT>1的例数较对照组显著增加(P<0.05);对于代谢指标的比较,观察组患者的腰围、舒张压、空腹血糖、血尿酸、三酰甘油及低密度脂蛋白胆固醇(LDL-C)水平较对照组显著升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.05),而两组在收缩压、总胆固醇的差异未见统计学意义(P>0.05);两组患者均易发冠心病、糖尿病及高血压等,观察组患者各项并发症发生率较对照组均显著升高(P<0.05)。结论 NAFLD合并MS发生率较高,患者多出现肝酶异常及代谢异常现象,同时易发糖尿病、高血压、冠心病等并发症。
Objective To investigate the clinical characteristics of non-alcoholic fatty liver disease (NAFLD) with metabolic syndrome (MS) and provide a theoretical basis for its clinical prevention and treatment. Methods 264 patients with NAFLD who were treated in Kaifeng Central Hospital from April 2010 to May 2012 were selected as observation group (NAFLD combined with MS) and control group (NAFLD only) Group of patients with liver enzymes, metabolic indicators and complications. Results The incidence of NAFLD complicated with MS was 46.97%, and its occurrence was not yet considered to be related to age and sex. For liver serum enzymology indexes, the alanine aminotransferase (ALT) and aspartate (P> 0.05), but the number of AST / ALT> 1 was significantly higher than that of the control group (P <0.05); for the comparison of the metabolic index, the observation group The waist circumference, diastolic blood pressure, fasting blood glucose, serum uric acid, triglyceride and low density lipoprotein cholesterol (LDL-C) were significantly higher than those in the control group (P < (P <0.05). There was no significant difference in systolic blood pressure and total cholesterol between the two groups (P> 0.05). Patients in the two groups were predisposed to coronary heart disease, diabetes and hypertension. The incidence of complications was significantly higher than that of the control group (P <0.05). Conclusions The incidence of MS with NAFLD is high. Patients with abnormal liver enzymes and abnormal metabolism often have complications such as diabetes, hypertension and coronary heart disease.