血清幽门螺旋杆菌抗体与非酒精性脂肪肝病的相关性研究
发布时间：2018-03-09 22:15
本文选题：非酒精性脂肪肝 切入点：幽门螺旋杆菌 出处：《延安大学》2017年硕士论文 论文类型：学位论文
【摘要】：目的:非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)是一些致命性疾病的潜在风险,如肝衰竭、肝癌、心血管疾病等,近年来,它的发病率呈逐年上升趋势,但是,目前却没有积极有效的治疗NAFLD的方案,仅以改善生活方式和控制饮食热量为NAFLD患者的金标准干预方案,因此本课题通过检测NAFLD中血清幽门螺旋杆菌(helicobacter pylori,HP)抗体阳性率,分析HP感染与NAFLD发病的相关性,旨在提高NAFLD的诊断率,为抗HP感染应用于治疗NAFLD提供新的理论基础,为NAFLD提供更好、更经济、更有效的治疗方案。方法:收集陕西省人民医院健康体检中心2016年3月-6月的体检人员的体检资料,所有人员均进行幽门螺旋杆菌检查及腹部B超检查,具有完整体检资料数据的体检者,经过严格筛选纳入本研究的共856人,男性476人,女性380人,根据腹部B超提示有无脂肪肝分为NAFLD组和对照组。采集的内容包括体检者一般资料,饮酒史,既往病史等。此外还有身高体重(BMI=体重/身高2),血压,FBG、HP抗体、血常规、血脂(TC、TG、HDL、LDL)、肝肾功、尿酸、ESR、hs-CRP、HbA1C,腹部超声检查和颈部超声检查,进行单因素分析HP与NAFLD的关系以及相关变量与NAFLD的关系,然后根据单因素分析中得出与NAFLD发病有关的变量,进行多因素分析,纳入logistic多元回归分析得出NAFLD的独立影响因子。结果:(1)202例NAFLD组72例HP抗体阳性,阳性率为35.64%,654例对照组145例HP抗体阳性,阳性率为22.17%,NAFLD组HP抗体阳性率明显高于对照组,NAFLD组与对照组两组比较P0.01;(2)单因素分析一般资料变量时,NAFLD组Age、SBP、DBP、FBG平均值均高于对照组,两组间比较P0.01;男性NAFLD的患病率明显高于女性,两组间比较P0.01;而BMI≥25kg/cm2、SBP≥130 mmHg、DBP≥85mmHg、HB≥150g/L、FBG≥6.1mmol/L、尿酸M420umol/L,F360umol/L时,NAFLD患病率明显升高,两组比较P0.05;(3)单因素分析血脂,NAFLD组TC、TG、LDL平均值均高于对照组,HDL低于对照组,两组间比较P0.001;当TC≥5.18mmol/L,TG≥1.7mmol/LDL≥3.37mmol/L时,NAFLD的患病率明显升高,两组间比较P0.001;(4)单因素分析肝功能指标时,NAFLD组ALT、AST、ALB平均值均高于对照组,两组间比较P0.001,差异有统计学意义;肝功能中ALT40U/L,AST40 U/L时,NAFLD患病率明显升高,两组间比较P0.001;(5)把所有单因素分析得出与NAFLD发病有关的变量进行多因素分析,纳入logistic多元回归分析得出NAFLD的独立影响因子,示HP抗体、BMI、尿酸的回归系数分别为1.397、-0.358、-0.006,OR值分别为4.041、0.699、0.994,P0.05。结论:(1)在NAFLD组中,HP抗体阳性率明显高于对照组,提示HP抗体与NAFLD的发病有相关性;(2)年龄、性别、BMI、血压、血糖、血脂、血红蛋白、血沉、尿酸、肝功指标(AST、ALT、ALB)与NAFLD的发病有相关性;(3)HP抗体、BMI、尿酸三者均是都是NAFLD发生的独立影响因子。
[Abstract]:Objective: nonalcoholic fatty liver disease (nonalcoholic fatty liver disease, NAFLD) is a potential risk for some fatal diseases, such as liver failure, liver cancer, cardiovascular disease, in recent years, its incidence increased year by year, but there is no effective treatment for NAFLD, only the gold standard NAFLD intervention with the solution to the improvement of life style and diet control, so this research by detection of NAFLD in serum of Helicobacter pylori (Helicobacter pylori, HP) antibody positive rate, correlation analysis of HP infection and the pathogenesis of NAFLD, to improve the diagnostic rate of NAFLD, provide a new theoretical foundation for the application in the treatment of anti HP infection NAFLD, NAFLD to provide better, more economical, more effective treatment options. Methods: the physical examination data collected medical examination center of Shaanxi People's Hospital health physical examination personnel in March 2016 -6 month, all the staff are quiet Clo examination and abdominal ultrasonography, with complete examination data of examination, after strict selection into a total of 856 people in the study, 476 male and 380 female, according to abdominal ultrasound showed fatty liver was divided into NAFLD group and control group. The acquisition included body examination data, drinking the history of previous history. In addition to height and weight (BMI= weight / height 2), blood pressure, FBG, HP antibody, blood routine, blood lipid (TC, TG, HDL, LDL), liver and kidney function, uric acid, ESR, hs-CRP, HbA1C, abdominal ultrasonography and cervical ultrasonography, the relationship between the single factor analysis of relationship between HP NAFLD and related variables and NAFLD, and then calculated according to relevant variables and the incidence of NAFLD in univariate analysis, multivariate analysis, independent factor into logistic multivariate regression analysis of NAFLD. Results: (1) in 202 cases of NAFLD group, 72 cases were HP antibody positive, the positive rate was 35.6 4%,654渚嬪鐓х粍145渚婬P鎶椾綋闃虫，
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