实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (2): 145-148.doi: 10.3969/j.issn.1672-5069.2014.02.009

• 乙型和丙型肝炎 • 上一篇    下一篇

男性慢性乙型肝炎患者肝细胞脂肪变危险因素分析

张鹏飞,阿丽亚·热哈提,范晓棠,希尔娜依·阿不都黑力力,董平,祝达,石绣江,陈兰,何方平   

  1. 830054 乌鲁木齐市 新疆医科大学第一附属医院肝病科
  • 收稿日期:2013-11-12 出版日期:2014-08-20 发布日期:2016-04-15
  • 通讯作者: 何方平 E-mail:hefp@sina.com
  • 作者简介:张鹏飞,女,24岁,硕士研究生。主要研究方向为各种肝病的基础和临床。E-mail: zhangpengfei2007@126.com
  • 基金资助:
    新疆维吾尔自治区科技支撑项目(编号:201141137);国家自然科学基金资助项目 (编号:81360138)

Risk factors of hepatic steatosis in male patients with chronic hepatitis B

Zhang Pengfei,Rehati Aliya,Fan Xiaotang,et al.   

  1. Department of Liver Disease,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011, China
  • Received:2013-11-12 Online:2014-08-20 Published:2016-04-15

摘要: 目的 比较男性慢性乙型肝炎(CHB)合并肝脂肪变患者与单纯CHB患者临床特征,寻找影响肝细胞脂肪变的危险因素。方法 2010年3月~2013年3月期间,住院初治且有肝活检病理学检查的男性CHB患者209例,根据肝组织中有无脂质沉积分为CHB合并脂肪变组及单纯CHB组,比较两组患者血脂、血尿酸、血糖、饮酒、体质量指数和病毒载量情况,进行二元Logistic回归分析,了解肝脂肪变的危险因素。结果 在209例男性CHB患者中,合并脂肪变121例(57.9%),单纯CHB 88例(42.1%);CHB合并脂肪变患者尿酸、低密度脂蛋白和甘油三酯分别为(352.5±87.1)mmol/L、(2.8±0.8)mmol/L 和(1.8±0.1)μmol/L,均显著高于单纯CHB患者[(310.3±69.1)mmol/L、(2.2±0.6) mmol/L和(1.2±0.7)μmol/L,P<0.01)];体质量指数和低密度脂蛋白水平升高是男性CHB患者合并肝脂肪变的危险因素(P<0.05)。结论 肥胖、血脂紊乱等代谢综合征相关表现是男性CHB患者肝组织脂肪变的危险因素,而饮酒或病毒载量可能不是肝脂肪变的危险因素。

关键词: 慢性乙型肝炎, 肝脂肪变, 危险因素, 代谢综合征, 男性

Abstract: Objective To analyze the difference in clinical features between male chronic hepatitis B(CHB) patients with or without hepatic steatosis and to search for the risk factors for hepatic steatosis. Methods Two hundred and nine male patients with CHB who were hospitalized for the first time and underwent liver biopsy from March 2010 to March 2013 were included in this study,and the patients were divided into two groups according to the presence or absence of hepatic steatosis;Serum lipids,uric acid,glucose,alcohol consumption, obesity,overweight and hepatitis B virus DNA load between the two groups were compared,and risk factors for hepatic steatosis were analyzed using binary logistic regression. Results Among the 209 patients,there were 121 cases(57.9%) with and 88(42.1%) without hepatic steatosis;Uric acid,low density lipoprotein and triglyceride were (352.5±87.1) mmol/L,(2.8±0.8) mmol/L and (1.8±0.1) μmol/L,respectively,in CHB patients with hepatic steatosis, all of which were remarkably higher than those in CHB patients without steatosis [(310.3±69.1)mmol/L,(2.2±0.6) mmol/L and(1.2±0.7)μmol/L, respectively,P<0.01)];Obesity,overweight and low density lipoprotein were the risk factors for hepatic steatosis(P<0.01). Conclusions Obesity and hyperlipidemia, but not viral load and alcohol consumption,are the risk factors for hepatic steatosis in male patients with CHB.

Key words: Chronic hepatitis B, Hepatic steatosis, Risk factors, Metabolic syndrome, Male