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非酒精性脂肪性肝病肝纤维化进展与内皮素-1/一氧化氮的关系

李品桦 刘旭东 黄露 朱沪敏 吴铁雄 庞华珍

引用本文:
Citation:

非酒精性脂肪性肝病肝纤维化进展与内皮素-1/一氧化氮的关系

DOI: 10.3969/j.issn.1001-5256.2021.11.015
基金项目: 

广西科学基金项目 (AB18221009)

广西中医药大学岐黄工程高层次人才团队培育项目 (2021007)

2019年广西一流学科建设课题 (2019XK139)

2019年中医药传承与创新人才培养平台建设项目 (National Traditional Chinese Medicine Education Letter No.41, 2019)

国家自然科学基金 (81473532)

详细信息
    通信作者:

    刘旭东,lxdlhx@163.com

  • 中图分类号: R575.2; R575.5

Association between liver fibrosis progression and endothelin-1/nitric oxide in patients with nonalcoholic fatty liver disease

Research funding: 

Guangxi Science Foundation Project (AB18221009);

High-Level Talent Team Cultivation Project of the Qihuang Project of Guangxi University of Traditional Chinese Medicine (2021007);

Guangxi First-Class Discipline Construction Project in 2019 (2019XK139);

Traditional Chinese Medicine Inheritance and Innovation Talents Training Platform Construction Project in 2019 (National Traditional Chinese Medicine Education Letter No.41, 2019);

National Natural Science Foundation of China (81473532)

  • 摘要:   目的  探讨非酒精性脂肪性肝病(NAFLD)肝纤维化进展是否会对内皮功能产生影响,以早期发现纤维化进展对内皮功能障碍所致心血管疾病的预警。  方法  选取2019年4月—2020年10月就诊于广西中医药大学附属瑞康医院肝病科门诊/住院,经超声诊断为脂肪肝且符合NAFLD诊断标准的患者280例,收集并记录患者的一般资料及各血清学指标。对超声诊断的NAFLD患者进行FibroTouch技术检测,分别记录其脂肪衰减度(FAP)及肝硬度值(LSM),根据LSM将研究对象分为非进展期纤维化组(LSM<11 kPa,n=239) 和进展期纤维化组(LSM≥11 kPa,n=41),比较分析NAFLD肝纤维化进展与内皮素-1(ET-1)、一氧化氮(NO)的关系。计量资料两组间比较采用t检验或Mann-Whitney U检验,相关性分析用Spearman分析方法。  结果  非进展期纤维化组和进展期纤维化组中ET-1(Z=-0.190, P=0.849)、NO(Z=-1.509, P=0.131)的表达水平比较差异无统计学意义。BMI、ALT、AST、GGT、TG、HDL-C在两组间比较差异均有统计学意义(Z值分别为-3.977、-4.162、-3.471、-3.201、-3.202、-3.311,P值均<0.05)。Spearman分析示,LSM与ET-1、NO、NO/ET-1无相关性(rs值分别为-0.046、0.086和0.104,P值均>0.05)。进一步分析了ET-1、NO与血脂、肝功能等指标的相关性,结果显示ET-1与年龄、NO、ALT、AST、GGT、TC、TG、HDL-C、LDL-C、FAP、BMI均不相关(P值均>0.05),NO与年龄、ET-1、ALT、AST、GGT、TC、TG、HDL-C、LDL-C、FAP、BMI各指标间也并无相关性(P值均>0.05)。  结论  在本研究中,NAFLD肝纤维化进展对ET-1、NO无影响,提示纤维化进展可能对内皮功能无影响。

     

  • 表  1  两组NAFLD患者ET-1、NO等血清学指标及一般资料比较

    指标 非进展期纤维化组
    (n=239)
    进展期纤维化组
    (n=41)
    统计值 P
    年龄(岁) 46.80±12.27 47.39±13.16 t=-0.280 0.577
    NO(μmol/L) 36.65(23.47~55.06) 43.96(33.25~57.66) Z=-1.509 0.131
    ET-1(pg/mL) 56.41(39.10~77.17) 57.71(39.98~73.49) Z=-0.190 0.849
    ALT(U/L) 26(18~39) 46(31~77) Z=-4.162 <0.001
    AST(U/L) 24(18~32) 34(22~61) Z=-3.471 0.001
    GGT(U/L) 36(25~56) 47(35~77) Z=-3.201 0.001
    TC(mmol/L) 5.00±1.04 4.70±1.31 t=1.601 0.083
    TG(mmol/L) 1.78(1.26~2.61) 1.29(0.92~1.82) Z=-3.202 0.001
    HDL-C(mmol/L) 1.13(1.00~1.35) 0.97(0.81~1.17) Z=-3.311 0.001
    LDL-C(mmol/L) 2.87±0.89 2.78±0.93 t=0.639 0.725
    FAP(db/m) 258.56±36.98 272.90±36.55 t=-2.297 0.552
    BMI(kg/m2) 26.39(24.44~28.69) 27.39(26.27~31.51) Z=-3.977 <0.001
    NO/ET-1 0.70(0.43~1.05) 0.75(0.54~1.18) Z=-1.291 0.197
    下载: 导出CSV

    表  2  ET-1、NO及NO/ET-1与LSM的相关性分析

    指标 rs P
    NO 0.086 0.153
    ET-1 -0.046 0.443
    NO/ET-1 0.104 0.082
    下载: 导出CSV

    表  3  ET-1与各指标的相关性分析

    指标 ET-1 NO
    rs P rs P
    年龄 -0.017 0.771 0.004 0.941
    NO/ET-1 0.054 0.369 0.054 0.369
    ALT -0.067 0.265 0.011 0.860
    AST -0.016 0.788 0.052 0.383
    GGT -0.031 0.603 0.004 0.951
    TC 0.004 0.952 -0.051 0.399
    TG 0.051 0.394 -0.052 0.389
    HDL-C -0.084 0.162 -0.012 0.729
    LDL-C -0.030 0.620 -0.076 0.205
    FAP 0.080 0.180 -0.013 0.832
    BMI 0.044 0.466 -0.021 0.729
    下载: 导出CSV
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  • 收稿日期:  2021-03-13
  • 录用日期:  2021-04-25
  • 出版日期:  2021-11-20
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