中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
5期
362-366
,共5页
曾民德%王炳元%陈成伟%施瑞华%厉有名%侯晓华%宣世英%邹晓平%李瑜元%江家骥%宋震亚%范建高%茅益民
曾民德%王炳元%陳成偉%施瑞華%厲有名%侯曉華%宣世英%鄒曉平%李瑜元%江傢驥%宋震亞%範建高%茅益民
증민덕%왕병원%진성위%시서화%려유명%후효화%선세영%추효평%리유원%강가기%송진아%범건고%모익민
脂肪肝%代谢综合征X%诊断%治疗
脂肪肝%代謝綜閤徵X%診斷%治療
지방간%대사종합정X%진단%치료
Fatty liver%Metabolic syndrome X%Diagnosis%Therapy
目的 了解非酒精性脂肪性肝病(NAFLD)患者中代谢相关指标的异常情况及日常诊疗的规范性.方法 收集中国12个地区21个医院门诊的成年NAFLD患者的临床基本信息,包括人口学特征(身高、体质量、腰围等),血压、血糖、血脂、肝功能,肝脏B超检查,记录患者的日常生活方式及诊疗情况,并参照我国2006年<非酒精性脂肪性肝病诊疗指南>进行评估.根据资料不用采用t检验、单因素方差分析或Pearson x2检验进行统计学分析.结果 1656例NAFLD患者参与此项调查性研究,其中男性1146例,女性510例,平均年龄(45.8±12.6)岁,病程为(47.2±47.7)个月.可以进评估的1587例NAFLD患者中有712例伴有代谢综合征,占44.9%.血压升高者和高密度脂蛋白胆固醇降低者中心性肥胖组分别为54.2%(605/1116)和38.2%(426/1116),无中心性肥胖组分别为45.4%(214/471)和31.6%(149/471),两组比较,x2值分别为10.2149及4.7975,P值均<0.05,差异有统计学意义.41.8%患者ALT异常,其人体质量指数、男女腰围、甘油三酯、低密度脂蛋白、空腹胰岛素、HOMA指数均高于ALT正常组,t值分别为5.1999、2.2255、2.3216、2.420、2.4950,4.4578、3.3397,P值均<0.05;而高密度脂蛋白胆固醇和舒张压低于ALT正常组,t值分别为3.5033和3.5626,P值均<0.05.人体质量指数、女性腰围、甘油三酯,空腹胰岛素、HOMA指数、ALT、AST等指标随B超脂肪肝轻、中、重程度呈升高趋势,而高密度脂蛋白胆固醇呈下降趋势.患者实际日常诊疗规范程度低于指南要求,其中使用胰岛素增敏剂和调脂药的分别仅达指南要求的15.3%和23.8%.结论 近半数NAFLD患者合并代谢综合征,日常诊疗现状距"非酒精性脂肪性肝病诊疗指南"要求差距较大.
目的 瞭解非酒精性脂肪性肝病(NAFLD)患者中代謝相關指標的異常情況及日常診療的規範性.方法 收集中國12箇地區21箇醫院門診的成年NAFLD患者的臨床基本信息,包括人口學特徵(身高、體質量、腰圍等),血壓、血糖、血脂、肝功能,肝髒B超檢查,記錄患者的日常生活方式及診療情況,併參照我國2006年<非酒精性脂肪性肝病診療指南>進行評估.根據資料不用採用t檢驗、單因素方差分析或Pearson x2檢驗進行統計學分析.結果 1656例NAFLD患者參與此項調查性研究,其中男性1146例,女性510例,平均年齡(45.8±12.6)歲,病程為(47.2±47.7)箇月.可以進評估的1587例NAFLD患者中有712例伴有代謝綜閤徵,佔44.9%.血壓升高者和高密度脂蛋白膽固醇降低者中心性肥胖組分彆為54.2%(605/1116)和38.2%(426/1116),無中心性肥胖組分彆為45.4%(214/471)和31.6%(149/471),兩組比較,x2值分彆為10.2149及4.7975,P值均<0.05,差異有統計學意義.41.8%患者ALT異常,其人體質量指數、男女腰圍、甘油三酯、低密度脂蛋白、空腹胰島素、HOMA指數均高于ALT正常組,t值分彆為5.1999、2.2255、2.3216、2.420、2.4950,4.4578、3.3397,P值均<0.05;而高密度脂蛋白膽固醇和舒張壓低于ALT正常組,t值分彆為3.5033和3.5626,P值均<0.05.人體質量指數、女性腰圍、甘油三酯,空腹胰島素、HOMA指數、ALT、AST等指標隨B超脂肪肝輕、中、重程度呈升高趨勢,而高密度脂蛋白膽固醇呈下降趨勢.患者實際日常診療規範程度低于指南要求,其中使用胰島素增敏劑和調脂藥的分彆僅達指南要求的15.3%和23.8%.結論 近半數NAFLD患者閤併代謝綜閤徵,日常診療現狀距"非酒精性脂肪性肝病診療指南"要求差距較大.
목적 료해비주정성지방성간병(NAFLD)환자중대사상관지표적이상정황급일상진료적규범성.방법 수집중국12개지구21개의원문진적성년NAFLD환자적림상기본신식,포괄인구학특정(신고、체질량、요위등),혈압、혈당、혈지、간공능,간장B초검사,기록환자적일상생활방식급진료정황,병삼조아국2006년<비주정성지방성간병진료지남>진행평고.근거자료불용채용t검험、단인소방차분석혹Pearson x2검험진행통계학분석.결과 1656례NAFLD환자삼여차항조사성연구,기중남성1146례,녀성510례,평균년령(45.8±12.6)세,병정위(47.2±47.7)개월.가이진평고적1587례NAFLD환자중유712례반유대사종합정,점44.9%.혈압승고자화고밀도지단백담고순강저자중심성비반조분별위54.2%(605/1116)화38.2%(426/1116),무중심성비반조분별위45.4%(214/471)화31.6%(149/471),량조비교,x2치분별위10.2149급4.7975,P치균<0.05,차이유통계학의의.41.8%환자ALT이상,기인체질량지수、남녀요위、감유삼지、저밀도지단백、공복이도소、HOMA지수균고우ALT정상조,t치분별위5.1999、2.2255、2.3216、2.420、2.4950,4.4578、3.3397,P치균<0.05;이고밀도지단백담고순화서장압저우ALT정상조,t치분별위3.5033화3.5626,P치균<0.05.인체질량지수、녀성요위、감유삼지,공복이도소、HOMA지수、ALT、AST등지표수B초지방간경、중、중정도정승고추세,이고밀도지단백담고순정하강추세.환자실제일상진료규범정도저우지남요구,기중사용이도소증민제화조지약적분별부체지남요구적15.3%화23.8%.결론 근반수NAFLD환자합병대사종합정,일상진료현상거"비주정성지방성간병진료지남"요구차거교대.
Objective To assess the characteristics and daily treatment compliance of non-alcoholic fatty liver disease (NAFLD) patients in China. Methods NAFLD adult patients from 21 clinics of 12 cities in China were enrolled in this registry. Physical examination such as demographic characteristics (height,weight, waist circumference measurement), blood pressure and clinical laboratory and ultrasonographic examination of liver were undertaken. Daily practice including life style and medication were recorded and assessed in accordance with 2006 Chinese NAFLD treatment guidelines. Results A total of 1656 patients were enrolled (1146 male and 510 female), mean of 45.8 ± 12.6 years old, mean duration of NAFLD history was (47.2 ± 47.7) months. 44.9% of NAFLD were suffering from metabolic syndromes. Patients with central obesity have higher incidence of hypertension and lower level of high-density lipoprotein cholesterol (HDL-C) than those without central obesity, P < 0.05. Body mass index (BMI), waist circumference, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in ALT abnormal group were higher than those in ALT normal group (P < 0.05), HDL-C was lower in ALT abnormal group (P < 0.05). Significant differences existed between the BMI, female waist circumference, TG, fast insulin, HOMA index, ALT, AST and HDLC among subgroups with mild, moderate and severe steatosis. Majority of the patients did not follow recommendations of NAFLD treatment guidelines. Among targeted population only 15.3% of patients used insulin sensitizers and 23.8% took lipid lowering medicine according to the guideline. Conclusion Data indicated that nearly half of NAFLD patients co-morbid with metabolic disorders. Therapy compliance was unsatisfactory and the gap between current practice and Chinese NAFLD treatment guidelines was not optimal.
