非酒精性脂肪肝患者的受控衰减参数与脂代谢异常及颈动脉粥样硬化的关系-东南大学学报医学版

非酒精性脂肪肝患者的受控衰减参数与脂代谢异常及颈动脉粥样硬化的关系

单位：南京中医药大学附属南京医院超声科, 江苏南京 210003

分类号：R575.5

出版年·卷·期（页码）：2020·39·第六期（835-838）

摘要：

目的：观察非酒精性脂肪肝（NAFL）患者受控衰减参数（CAP）与血脂代谢异常及颈动脉粥样硬化的关系。方法：选择115例NAFL患者（为NAFL组），按CAP的大小分为轻度组21例、中度组32例、重度组62例；无脂肪肝61例作为对照组。两组均测定血甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和颈动脉中层内膜厚度（IMT），超声观察颈动脉是否存在粥样斑块和斑块厚度。结果：NAFL组的TC、LDL-C、CAP、IMT值分别为（5.2±0.3）mmol·L^-1、（3.7±0.5）mmol·L^-1、（302±38）dB·m^-1，（1.2±0.4）mm，均显著高于对照组的（4.6±0.5）mmol·L^-1、（2.3±0.4）mmol·L^-1、（197±44）dB·m^-1、（1.0±0.2）mm（P<0.05）。NAFL组的颈动脉斑块发生率为29.6%，显著高于对照组的13.1%（P<0.05）。结论：脂肪肝患者存在不同程度的血脂代谢异常，具有较高的颈动脉硬化发生率。

Objective: To observe the relationship between the controlled attenuation parameter(CAP), dyslipidemia and carotid atherosclerosis in patients with nonalcoholic fatty liver(NAFL). Methods: 115 patients with NAFL were divided into the mild group(21 cases), the moderate group(32 cases) and the severe group(62 cases) according to their CAP values. 61 cases without fatty liver were taken as the control group. TG, TC, HDL-C, LDL-C and the carotid intimal thickness were measured in both groups, and the presence of carotid atherosclerotic plaque was evaluated by ultrasonography. Results: The values of TC, LDL-C, CAP and IMT in NAFL group were(5.2±0.3)mmol·L^-1, (3.7±0.5)mmol·L^-1, (302±38)dB·m^-1 and (1.2±0.4)mm, respectively. The values of TC, LDL-C, CAP and IMT in the control group were(4.6±0.5)mmol·L^-1, (2.3±0.4)mmol·L^-1, (197±44)dB·m^-1 and (1.0±0.2)mm, respectively. The values of TC, LDL-C, CAP and IMT in NAFL group were significantly higher than those in the control group(P<0.05). The incidence of carotid plaque in NAFL group(29.6%) was significantly higher than that in the control group(13.1%)(P<0.05). Conclusion: Patients with NAFL have various degrees of lipid metabolism disorder, with a higher incidence of carotid atherosclerosis.

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