乌鲁木齐市社区中年人群非酒精性脂肪肝患病风险及社区干预效果研究

发布时间：2018-05-05 02:06

本文选题：非酒精性脂肪肝 + 患病率　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:本研究旨在调查乌鲁木齐市社区中年人群非酒精性脂肪肝(Nonalcoholic fatty liver disease,NAFLD)的患病情况,分析流行特点及其主要相关危险因素;并对发现的NAFLD患者进行社区干预,以减轻患者的脂肪肝程度,促进患者的整体健康水平,从而为今后开展该疾病的防治及干预方式提供理论依据。方法:以街道社区为单位,采取整群抽样方法,通过问卷咨询、体格测量(身高、体重、血压、腰围、臀围、颈围、皮下脂肪厚度)、血液生化(包括肝功能、空腹血糖、尿酸)检查以及腹部肝脏B超检查,调查社区中年人群NAFLD患病情况,从而分析其主要相关危险因素;并对筛检出的NAFLD患者以社区为单位随机分为干预组与对照组进行社区干预,探寻科学的干预方法,以期达到早发现,早治疗的二级预防,从而降低医疗成本,促进人群健康。结果:1.新疆乌鲁木齐市社区中年人群844人中,NAFLD患者检出456人,患病率为54.03%;2.维吾尔族和汉族NAFLD的患病率分别为64.71%和48.66%,维吾尔族人群高于汉族人群,差异有统计学意义(P0.05);3.在男性人群中,NAFLD组与正常组人群的BMI、SBP、DBP、腰围、臀围、颈围、皮下脂肪厚度、UA、ALT水平相比有统计学意义(P0.05),在女性人群中,NAFLD组与正常组人群的BMI、SBP、DBP、腰围、臀围、颈围、皮下脂肪厚度、FPG、UA、ALT、AST水平相比均具有统计学意义(P0.05);4.在维吾尔族人群中,NAFLD组与正常组人群BMI、SBP、腰围、臀围、皮下脂肪厚度、FPG、ALT、AST对比均具有统计学意义(P0.05),在汉族人群中,NAFLD组与正常组人群的BMI、SBP、DBP、腰围、臀围、颈围、皮下脂肪厚度、ALT、AST水平相比均具有统计学意义(P0.05);5.既往史与NAFLD单因素logistic回归分析结果显示,糖尿病、高脂血症、胆囊炎、胆石症均与NAFLD具有相关性(P0.05);6.临床观察指标与NAFLD单因素logistic回归分析结果显示,BMI、SBP、DBP、腰围、臀围、颈围、皮下脂肪、FPG、ALT、AST水平均与NAFLD具有相关性(P0.05);7.男性肥胖指标预测NAFLD发生,腰围、臀围、皮下脂肪、颈围的曲线下面积依次为0.711、0.668、0.652、0.649;女性肥胖指标预测NAFLD发生,腰围、臀围、颈围、皮下脂肪的曲线下面积依次为0.790、0.760、0.710、0.697;8.将筛检出的NAFLD患者进行社区干预后,干预组有17例患者痊愈,对照组有10例患者痊愈(干预前两组NAFLD患病程度进行统计学检验,具有可比性,2x=0.892,P=0.640);9.干预组与对照组NAFLD患者在干预前后,BMI、SBP、DBP、腰围、臀围、颈围、皮下脂肪厚度、FPG、UA、ALT、AST水平均有所变化;10.干预组与对照组干预结局时期BMI、SBP、DBP、腰围、颈围、皮下脂肪厚度、UA水平变化值均具有统计学意义(P0.05)。结论:1.乌鲁木齐市社区中年人群的NAFLD患病率较高,提示应对乌市社区居民NAFLD的防治应引起更多关注;2.NAFLD的发生与多种因素相关,包括性别、年龄、BMI、血压、腰围、臀围、颈围、皮下脂肪厚度、空腹血糖、尿酸、丙氨酸氨基转移酶、天冬氨酸氨基转移酶等;3.NAFLD的防治主要是去除致病危险因素,通过健康教育,注意饮食调整、科学有效控制体重、定期体检,改善不良生活行为方式及习惯、注重规律地运动及锻炼,必要时采用药物治疗等一系列综合措施,达到消退NAFLD,进而有效防止疾病发展与并发症发生。
[Abstract]:Objective: the purpose of this study was to investigate the prevalence of Nonalcoholic fatty liver disease (NAFLD) in middle-aged people in Urumqi community, to analyze the epidemic characteristics and the main related risk factors, and to intervene in the found NAFLD patients by community intervention in order to reduce the degree of fatty liver and promote the overall health of the patients. In order to provide a theoretical basis for the prevention and intervention of the disease in the future, a cluster sampling method is adopted in a street community as a unit, with a questionnaire, physical measurement (height, weight, blood pressure, waist circumference, hip circumference, subcutaneous fat thickness), blood biochemistry (including liver function, fasting blood glucose, uric acid), and B of the abdominal liver. To investigate the prevalence of NAFLD in the middle age community of the community, and to analyze the main related risk factors, and to divide the NAFLD patients into the community as the intervention group and the control group to explore the scientific intervention methods so as to achieve the early detection and the two level prevention of early treatment, thus reducing the cost of medical treatment and promoting the promotion of medical costs. Results: among the 844 middle-aged people in 1. Xinjiang Urumqi community, 456 were detected in NAFLD patients, the prevalence rate was 54.03%, and the prevalence rate of 2. Uygur and Han nationality was 64.71% and 48.66% respectively. The Uygur population was higher than the Han population, the difference was statistically significant (P0.05); 3. in the male population, and the B of the NAFLD group and the normal group. MI, SBP, DBP, waist circumference, hip circumference, neck circumference, subcutaneous fat thickness, UA, ALT levels were statistically significant (P0.05). In female population, the NAFLD group was statistically significant compared with the normal group of BMI, SBP, DBP, waist circumference, neck circumference, subcutaneous fat thickness, FPG, UA, and normal levels. 4. in Uygur population, normal group and normal Group BMI, SBP, waist circumference, hip circumference, subcutaneous fat thickness, FPG, ALT, AST were statistically significant (P0.05). In the Han population, BMI, SBP, DBP, waistline, hip circumference, neck circumference, subcutaneous fat thickness, ALT, AST level were statistically significant in the Han population. 5. past history and single factor regression analysis The results showed that diabetes, hyperlipidemia, cholecystitis, cholelithiasis were all associated with NAFLD (P0.05); 6. the clinical observation index and NAFLD single factor Logistic regression analysis showed that BMI, SBP, DBP, waist circumference, hip circumference, subcutaneous fat, FPG, ALT, AST water were associated with NAFLD (P0.05); 7. male obesity indicators predicted occurrence, waist The area under the curve of circumference, hip circumference, subcutaneous fat and neck circumference was 0.711,0.668,0.652,0.649 in turn; female obesity index predicted NAFLD, waist circumference, hip circumference, neck circumference, and subcutaneous fat under the curve area of 0.790,0.760,0.710,0.697; 8. the NAFLD patients screened out for community prognosis, 17 patients in the intervention group were healed, and 10 cases in the control group. The patients were cured (statistical test of the two groups of NAFLD diseases before intervention, comparable, 2x=0.892, P=0.640); 9. the intervention group and the control group NAFLD patients before and after intervention, BMI, SBP, DBP, waist circumference, neck circumference, subcutaneous fat thickness, FPG, UA, ALT, AST water change; 10. intervention group and the control group intervention outcome period BMI, wealth, waist circumference The changes in the neck circumference, the thickness of the subcutaneous fat and the UA level were all statistically significant (P0.05). Conclusion: 1. the prevalence of NAFLD in middle-aged people in Urumqi community is higher, suggesting that the prevention and control of NAFLD should be more concerned. The occurrence of 2.NAFLD is related to a variety of factors, including sex, age, BMI, blood pressure, waist circumference, hip circumference, and neck circumference. The thickness of subcutaneous fat, fasting blood sugar, uric acid, alanine aminotransferase, aspartate aminotransferase, and so on. The prevention and control of 3.NAFLD is mainly to remove the risk factors of pathogenic factors. Through health education, attention to diet adjustment, scientific and effective control of weight, regular physical examination, improvement of unhealthy lifestyle and habits, and attention to regular exercise and exercise, necessary to exercise and exercise, need to be regularly exercised and exercised. Necessary A series of comprehensive measures such as drug therapy were used to achieve NAFLD regression and effectively prevent disease progression and complications.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

【参考文献】