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ALT与AST比值预测慢性丙型肝炎患者肝脂肪变性的可行性分析
Feasibility of alanine aminotransferase/aspartate aminotransferase ratio in predicting hepatic steatosis in chronic hepatitis C patients
文章发布日期:2017年05月04日  来源:  作者:张秀丽  点击次数:161次  下载次数:16次

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【摘要】:目的评价ALT/AST值预测慢性丙型肝炎(CHC)患者肝脂肪变性程度的可行性。方法选择2012年5月-2016年6月就诊于南阳市第一人民医院的CHC患者231例,其中非酒精性脂肪性肝病(NAFLD)患者105例(45.45%),非NAFLD患者126例(54.55%);同时根据B超评分将NAFLD组分为轻中度(1~2分)脂肪变性组(n=67)和重度(3分)脂肪变性组(n=38)。比较NAFLD组和非NAFLD组人口学及肌酐、空腹血糖、ALT、AST、ALT/AST、GGT、尿酸、LDL、HDL、CHO、TG等病情资料,筛选CHC合并NAFLD的独立危险因素。符合正态分布的计量资料组间比较采用独立样本t检验;不符合正态分布的数据组间比较采用Wilcoxon秩和检验;计数资料组间比较采用χ2检验;以重度NAFLD为因变量,不同因素引入logostic回归方程筛选独立危险因素。结果NAFLD组收缩压、舒张压、空腹血糖、ALT、ALT/AST值、GGT、HDL、CHO、TG和糖尿病、高血压、代谢综合征比例高于非NAFLD组(P值均<005);轻中度组收缩压、舒张压、空腹血糖、ALT、ALT/AST值、GGT、HDL、CHO、TG和糖尿病、高血压、代谢综合征比例低于重度组(P值均<0.05);logistic回归分析表明代谢综合征、ALT、ALT/AST值为NAFLD的独立危险因素(P值均<0.05),代谢综合征、ALT、ALT/AST值、GGT为重度NAFLD的独立危险因素(P值均<0.05)。结论ALT/AST值是CHC合并NAFLD的独立危险因素,对判断NAFLD病变程度也有一定的价值。
【Abstract】:ObjectiveTo investigate the feasibility of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC) patients. MethodsA total of 231 CHC patients who visited The First People′s Hospital of Nanyang from May 2012 to June 2016 were enrolled, among whom 105 (45.45%) had nonalcoholic fatty liver disease (NAFLD) and 126 (54.55%) did not have NAFLD. According to the ultrasound score, the NAFLD group was divided into mild-to-moderate (1-2 points) hepatic steatosis group(n=67) and severe (3 points) hepatic steatosis group(n=38). The two groups were compared in terms of demographic data and disease data including creatinine, fasting blood glucose, ALT, AST, ALT/AST ratio, γ-glutamyltransferase (GGT), uric acid, low-density lipoprotein, high-density lipoprotein (HDL), cholesterol (CHO), and triglyceride (TG) to screen out independent risk factors for NAFLD in CHC patients. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; with severe NAFLD as the dependent variable, different factors were introduced into the logistic regression equation to screen out independent risk factors. ResultsCompared with the non-NAFLD group, the NAFLD group had significantly higher systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as well as a significantly higher proportion of patients with diabetes, hypertension, or metabolic syndrome (all P<0.05). Compared with the severe hepatic steatosis group, the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as well as a significantly lower proportion of patients with diabetes, hypertension, or metabolic syndrome (all P<0.05). The logistic regression analysis showed that metabolic syndrome, ALT, and ALT/AST ratio were independent risk factors for NAFLD (all P<005), and metabolic syndrome, ALT, ALT/AST ratio, and GGT were independent risk factors for severe NAFLD (all P<0.05). ConclusionALT/AST ratio is an independent risk factor for NAFLD in CHC patients and has a certain value in evaluating the degree of NAFLD.
【关键字】:肝炎, 丙型, 慢性; 脂肪肝; 丙氨酸转氨酶; 天冬氨酸氨基转移酶类
【Key words】:hepatitis C, chronic; fatty liver; alanine transaminase; aspartate aminotransferases
【引证本文】:张秀丽. ALT与AST比值预测慢性丙型肝炎患者肝脂肪变性的可行性分析[J]. 临床肝胆病杂志, 2017, 33(6): 1096-1100.

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