单纯性非酒精性脂肪肝与非酒精性脂肪性肝炎临床特征比较

目的 探讨单纯性非酒精性脂肪肝（NAFL）与非酒精性脂肪性肝炎（NASH）患者临床相关因素的异同点.方法 收集2006年6月～2010年6月间我院住院及门诊资料完整的非酒精性脂肪性肝病（NAFLD）患者150例,其中非酒精性脂肪性肝炎65例,非酒精性脂肪肝85例,比较两组患者年龄、体重指数（BMI）、临床表现、实验室检查和合并症等因素.结果 非酒精性脂肪性肝炎组患者BMI、血清铁蛋白、IV型胶原、空腹胰岛素、空腹血糖、胰岛素抵抗指数、代谢综合症等相关疾病的发生率较非洒精性脂肪肝组明显增多,差异有显著性（P〈0.05）,其余指标比较差异无显著性.结论 非酒精性脂肪肝组与非酒精性脂肪性肝炎组患者非特异性症状（如疲劳、乏力等）的发生率及肝功能比较尤显著性差异;非酒精性脂肪性肝炎组并发症（如2型糖尿病等）较非洒精性脂肪肝组突出;非酒精性脂肪性肝炎组BMI、血清铁蛋白、Ⅳ型胶原、空腹血糖、空腹胰岛素、胰岛素抵抗指数等血清学指标较非酒精性脂肪肝组显著升高.

The clinc features between non-alcoholic fatty liver and nonalcoholic steatohepatitis

Objective To investigate the similarities and differences between non-alcoholic fatty liver and non-alcoholic steatohepatitis, for assistance to the clinical diagnosis and treatment. Methods 150 cases of non-alcoholic fatty liver disease ,who were from the first Hospital of Wenzhou Medical College from Jun. 2006 to Jun. 2010,were divided into non-alcoholic fatty liver group（85 cases） and non-alcoholic steatohepatitis group （65 cases）. Age, body mass index, clinical manifestations, laboratory findings and complications in the two groups were analysed and compared retrospectively. Results In NASH group, BMI, serum ferritin, IV collagen, Insulin resistance index（ HOWA-IR）, fasting glucose （FPG）, Fasting insulin（FINS） , and the incidence of metabolic syndrome related the diseases increased significantly compared with NAFL;no difference in other parameters. Conclusions There were no difference in Liver function tests and the incidence of non-specific symptoms （ such as fatigue fatigue, etc. ） between NAFL and NASH;In NASH group, complications （such as type 2 diabetes） were more prominent compared with NAFL; In NASH group, BMI, serum ferritin, IV collagen, fasting glucose, fasting insulin and insulin resistance index were significantly higher than the NAFL group.