代谢综合征与慢性乙型病毒性肝炎及非酒精性脂肪性肝病患者肝纤维化程度的相关性研究

目的 比较慢性乙型病毒性肝炎患者和非酒精性脂肪性肝病患者代谢综合征患病率,以及代谢综合征对慢性乙型病毒性肝炎患者和非酒精性脂肪性肝病患者肝纤维化进展的影响.方法 对2008年1月至2009年6月在我院就诊的136例慢性乙型病毒性肝炎患者和110例非酒精性脂肪性肝病患者进行回顾性分析,调查其代谢综合征的患病率,测定肝功能及病毒学指标,进行肝脏病理学检查.采用t检验和X~2检验进行统计学分析.结果 代谢综合征总的患病率为28.5%,非酒精性脂肪性肝病患者代谢综合征患病率显著高于慢性乙型病毒性肝炎患者(分别为49.1%和11.8%).肝纤维化分期为S_(0～1)、S_(2～4)的慢性乙型病毒性肝炎患者代谢综合征的患病率分别为3.1%和19.7%(P＜0.01),代谢综合征、体重指数、天门冬氨酸转氨酶、γ-谷氨酰转肽酶及炎症程度均与其肝纤维化程度相关.在非酒精性脂肪性肝病患者中,非酒精性脂肪性肝炎患者代谢综合征患者率高于非酒精性脂肪肝(分别为55.4%和40.0%);纤维化分期为S_(0～1)、S_(2～4)的患者代谢综合征的患病率分别为36.2%和70.7%(P＜0.01);代谢综合征、丙氨酸转氨酶、天门冬氨酸转氨酶、γ-谷氨酰转肽酶及明显炎症均与其肝纤维化严重程度相关.结论 非酒精性脂肪性肝病患者代谢综合征的患病率高于慢性乙型病毒性肝炎患者,这两类患者代谢综合征与肝纤维化程度相关.

Metabolic syndrome and severity of fibrosis in patients with chronic viral hepatitis B infection or non-alcoholic fatty liver disease

Objective To investigate the prevalence of metabolic syndrome(MS)in patients with chronic viral hepatitis B(HBV)infection or non-alcoholic fatty liver disease(NAFLD),and to determine the relationship between MS and the risk of fibrosis in those patients.Methods One hundred and thirty-six patients with chronic HBV infections and 110 NAFLD patients were retrospectively analyzed from January 2008 to June 2009 for the prevalence of MS.Histological and laboratory assessment was received,t or X~2 test was used for data analysis.Results The prevalence of MS of the NAFLD group was significantly higher than that of the HBV infection group(49.1% and 11.8%,respectively;P ＜0.01).In the patients with chronic HBV infection,severity of fibrosis was associated with increasing body mass index(BMI),higher aspartate aminotransferase(AST),gamma-glutamyl-transpeptidase(GGT),severe necroinflammation,and MS.In NAFLD group,MS was more prevalent in patients with non-alcoholic steatohepatitis(NASH)than simple fatty liver(55.4% and 40.0%,respectively;P ＜ 0.01);severity of fibrosis was associated with MS,higher alanine transarninase(ALT),AST,GGT,and severe necroinflammation.Conclusion MS may be more prevalent in NAFLD patients,and might be associated with the severity of fibrosis in patients with chronic HBV infection or NAFLD.