非酒精性脂肪性肝病患者粪便钙卫蛋白检测及其意义*

目的 探讨粪便钙卫蛋白（FC）评估非酒精性脂肪性肝病（NAFLD）患者肠道炎症状态的应用价值。方法 纳入NAFLD和健康人,采用酶联免疫吸附试验检测粪便钙卫蛋白水平,并收集两组研究对象的一般资料和血生化指标。结果 91例正常人和81例NAFLD患者体质指数（BMI）分别为（22.6±2.4） kg/m²和（28.5±4.0） kg/m²,腰围分别为（80.9±7.9） cm和（91.6±9.5） cm,血清谷草转氨酶（AST）分别为（19.3±4.8） u/L和（33.7±18.7） u/L,谷丙转氨酶（ALT）分别为（17.5±7.1） u/L和（55.0±44.5） u/L,甘油三酯（TG）分别为（0.9±0.3） mmol/L和（2.4±2.3） mmol/L,总胆固醇（TC）分别为（4.3±0.6） mmol/L和（5.1±1.3） mmol/L,差异均有统计学意义（P<0.05）;NAFLD组FC水平为43.0（18.8~87.0）μg/g,显著高于正常人的11.4（4.6~24.4）μg/g,差异有统计学意义（P<0.00）;NAFLD组和正常人FC水平大于50 μg/g者分别为48例（59.3%）和6例（6.6%）,两者构成比差异具有统计学意义（x²=55.178,P<0.001）;相关性分析显示,NAFLD患者FC水平与BMI、腰围、血清GGT、TC水平呈正相关（r=0.725,r=0.570,r=0.292,r=0.400,P值均<0.05）;多因素分析发现,低水平的HDL、高水平的TG、BMI和TC是NAFLD发病的独立危险因素（OR=0.011,OR=13.558,OR=1.821,OR=3.086,P值均<0.01）。结论 NAFLD患者粪便FC水平升高,反映肠道可能存在一定的炎症。

Fecal calprotectin measurement in patients with non-alcoholic fatty liver disease

Objective To assess the state of gut inflammation in patients with non-alcoholic fatty liver diseae （NAFLD） by using fecal calprotectin measurement. Methods In NAFLD patients and healthy persons,the fecal calprotectin levels were measured by enzyme-linked immunosorbent assay,and the demographic data and biochemical parameters were collected. Results Eighty-one NAFLD patients and 91 healthy subjects were recruited in this study. The body mass index（BMI） in the healthy controls and in the NAFLD patients were （22.6±2.4） kg/m² vs. （28.5±4.0） kg/m²,waist circumference were（80.9±7.9） cm vs. （91.6±9.5） cm,AST was （19.3±4.8） IU/L vs. （33.7±18.7） IU/L,ALT was （17.5±7.1） IU/L vs. （55.0±44.5） IU/L,TG was（0.9±0.3） mmol/L vs. （2.4±2.3） mmol/L,TC was（4.3±0.6） mmol/L vs. （5.1±1.3） mmol/L,all of the difference were statistically significant（P<0.05）;the fecal calprotectin levels in the patients with NAFLD was 43.0（18.8~87.0）μg/g,much higher than 11.4（4.6~24.4） μg/g in the control （P<0.001）;There were positive correlations between fecal calprotectin levels and BMI,waist circumference,TC and GGT（r=0.725,r=0.570,r=0.292,and r=0.400,respectively,all P<0.010）;Multivariate analysis demonstrated that a low level of HDL,and a high level of TG,BMI,and TC were independent risk factors for NAFLD（OR=0.011,OR=3.558,OR=1.821,OR=3.086,respectively,all P<0.01）. Conclusion Fecal calprotectin levles increases in NAFLD patients,which might reflect the inflammation state of the gut.