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[目的]探讨影响酒精性脂肪肝患者颈动脉粥样硬化斑块的因素。[方法]选取经B超诊断符合酒精性脂肪肝的99例、无脂肪肝的53例患者作为研究对象。根据颈动脉斑块超声检测结果将152例患者分为无颈动脉粥样硬化斑块的酒精性脂肪肝组(A组)、有颈动脉粥样硬化斑块的酒精性脂肪肝组(B组)、既无颈动脉粥样硬化斑块亦无脂肪肝组(C组)、有颈动脉粥样硬化斑块但无脂肪肝组(D组);对各组年龄、血脂、载脂蛋白、体质指数(BMI)、血糖、尿酸(UA)及肝肾功能进行比较。[结果]B组患者年龄高于A组和C组,D组年龄高于A组;A组BMI、总胆固醇(TC)、三酰甘油(TG)和极低密度脂蛋白(VLDL)均明显高于C组,A组TG和VLDL较D组明显升高,B组TG明显高于C组和D组;A组、B组载脂蛋白B较C组明显升高;A组UA较B组、C组和D组均明显升高,B组UA较C组和D组均明显升高;B组谷丙转氨酶明显高于C组,A组谷草转氨酶、γ-谷氨酰转移酶(γ-GT)均明显高于C组和D组,B组γ-GT高于C组和D组,B组碱性磷酸酶高于A组;A组肌酐明显低于C组。[结论]酒精性脂肪肝有促进颈动脉粥样硬化斑块提早发生的倾向,可能与其引起的BMI、脂质、UA增加及肝肾功能代谢紊乱有关。
[Objective] To investigate the factors affecting carotid atherosclerotic plaque in patients with alcoholic fatty liver. [Method] Totally 99 cases of alcoholic fatty liver diagnosed by B ultrasound and 53 cases of non-fatty liver were selected as the research object. According to the results of carotid plaque ultrasonic examination, 152 patients were divided into alcoholic fatty liver group without carotid atherosclerotic plaque (group A), alcoholic fatty liver group with carotid atherosclerotic plaque (group B ), Neither carotid atherosclerotic plaque nor fatty liver group (C group), carotid atherosclerosis plaque but no fatty liver group (D group); the age, blood lipid, apolipoprotein, Body mass index (BMI), blood glucose, uric acid (UA) and liver and kidney function were compared. [Result] The age of group B was higher than that of group A and C, and the age of group D was higher than that of group A. The BMI, total cholesterol (TC), triglyceride (TG) and VLDL of group A were significantly Higher than C group, TG and VLDL in group A were significantly higher than those in group D, TG in group B was significantly higher than those in group C and group D. Apolipoprotein B in group A and group B was significantly higher than that in group C. UA in group A was significantly higher than that in group B Group C and group D were significantly increased, group B UA than group C and group D were significantly increased; group B alanine aminotransferase was significantly higher than group C, group A aspartate aminotransferase, γ-glutamyl transferase ( γ-GT) were significantly higher than those in group C and group D. The level of γ-GT in group B was higher than those in group C and D. The level of alkaline phosphatase in group B was higher than that in group A; [Conclusion] Alcoholic fatty liver has a tendency to promote the early occurrence of carotid atherosclerotic plaques, which may be related to the increase of BMI, lipid, UA and disorder of liver and kidney function.