慢性乙型肝炎患者合并肝脂肪变性危险因素的病例对照研究

目的探讨慢性乙型肝炎（CHB）肝脂肪变性的危险因素。方法180例经肝活检的CHB患者，其中合并肝脂肪变性患者与无肝脂肪变性患者按照性别相同、年龄±3岁进行1：1匹配，分为病例组（61例，合并肝脂肪变性）与对照组（61例，无脂肪变性），进行病例对照分析，探讨肝脂肪变性的危险因素。结果病例组体重指数24±3，显著高于对照组22±3（P〈0．01），而空腹血糖、总胆固醇、甘油三酯、尿酸、丙氨酸氨基转移酶、γ-谷氨酰转肽酶及乙型肝炎病毒（HBV）DNA水平与对照组差异均无统计学意义（均P〉0．05）。经COX模型拟合进行配对资料logistic回归分析，仅体重指数为肝脂肪变性的独立危险因素（OR=1．488，P〈0．01）。结论CHB患者肝脂肪变性与宿主体重指数有关，而与HBVDNA水平无关。

Risk factors for hepatic steatosis in patients with chronic hepatitis B:a case-control study

Objective To investigate risk factors for hepatic steatosis in patients with chronic hepatitis B (CHB). Methods One hundred and eighty patients with biopsy-proven chronic hepatitis B were included in the study. Those with liver steatosis (61 from 93 cases) and those without it (61 from 87 cases)were matched on gender and age ( ± 3 years). Results Body mass index (BM I) was significantly higher in case group (24 ±3) than that in controls (22 ±3) (P ＜0.01 ). No significant difference was found in fasting plasma glucose, total cholesterol, triglycerides, urine acid, alanine aminotransferase, glutamyl transpeptidase and hepatitis B virus ( HBV ) DNA between the cases and controls ( all P ＞ 0. 05 ).Conditional logistic regression analysis with proportional hazard regression model statement by SPSS software showed that BMI was the only independent correlate to liver steatosis in patient with CHB ( OR = 1. 488, P ＜0. 01 ). Conclusions Liver steatosis in patients with CHB associates with BMI of the hosts, but does not correlate to their HBV DNA level.