2型糖尿病合并非酒精性脂肪性肝病患者早期肝纤维化的相关因素分析

发布时间：2018-03-26 02:31

  本文选题：2型糖尿病　切入点：非酒精性脂肪性肝病　出处：《吉林大学》2017年硕士论文

【摘要】：目的:分析2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者早期肝纤维化的相关因素,并对其危险性进行浅要分析。方法:选取2015年2月至2015年12月吉林大学中日联谊医院内分泌科住院的137例2型糖尿病患者,所有患者均行肝脏彩超检查并明确诊断为NAFLD,分别采集病史资料、临床生化指标、并算出非酒精性脂肪性肝纤维化评分(NAFLDFS)与胰岛素抵抗指数(HOMA2-IR)。将研究对象按NAFLDFS的诊断阈值进行分组,其中NAFLDFS-1.455为A组,-1.455≤NAFLDFS≤0.676之间为B组,NAFLDFS0.676为C组;比较各组间一般临床资料和生化指标的差异,用多项Logistics回归分析得出影响肝纤维化的危险因素。结果:(1)超声诊断的NAFLD合并T2DM患者共137例(男//女,76/61),其中NAFLDFS0.676的为33例(24.1%),NAFLDFS在-1.455~0.676之间者83例(60.6%),NAFLDFS-1.455者21例(15.3%)。(2)Pearson分析显示进展性肝纤维化与年龄、BMI、SBP、HOMA2-IR呈线性正相关;与RBC、WBC、PLT、ALT、AST、TG、TC呈线性负相关。(3)Logistic回归分析结果显示HOMA-IR、收缩压升高和RBC、WBC、TC减少是T2DM合并NAFLD肝纤维化的危险因素(OR=1.279、1.076、0.374、0.674、0.574)。结论:胰岛素抵抗、收缩压与肝纤维化评分成正相关,提示其是肝纤维化的危险因素;而白细胞、红细胞及总胆固醇与肝纤维化评分呈负相关,提示其是肝纤维化的保护性因素。
[Abstract]:Objective: to analyze the related factors of early hepatic fibrosis in patients with type 2 diabetes mellitus (T2DM) combined with NAFLD. Methods: from February 2015 to December 2015, 137 patients with type 2 diabetes were selected from the Department of Endocrinology, Sino-Japanese Friendship Hospital of Jilin University. All patients were examined with liver color Doppler ultrasound and diagnosed as NAFLD.The history data and clinical biochemical indexes were collected respectively. The nonalcoholic fatty liver fibrosis score (NAFLDFSs) and the insulin resistance index (HOMA2-IRN) were calculated. The subjects were grouped according to the diagnostic threshold of NAFLDFS, and the NAFLDFS-1.455 was between group A (-1.455 鈮，

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