本文選題：非酒精性脂肪肝 + 患病率　； 參考：《新疆醫(yī)科大學》2017年碩士論文

【摘要】：目的:本研究旨在調查烏魯木齊市社區(qū)中年人群非酒精性脂肪肝(Nonalcoholic fatty liver disease,NAFLD)的患病情況,分析流行特點及其主要相關危險因素;并對發(fā)現的NAFLD患者進行社區(qū)干預,以減輕患者的脂肪肝程度,促進患者的整體健康水平,從而為今后開展該疾病的防治及干預方式提供理論依據。方法:以街道社區(qū)為單位,采取整群抽樣方法,通過問卷咨詢、體格測量(身高、體重、血壓、腰圍、臀圍、頸圍、皮下脂肪厚度)、血液生化(包括肝功能、空腹血糖、尿酸)檢查以及腹部肝臟B超檢查,調查社區(qū)中年人群NAFLD患病情況,從而分析其主要相關危險因素;并對篩檢出的NAFLD患者以社區(qū)為單位隨機分為干預組與對照組進行社區(qū)干預,探尋科學的干預方法,以期達到早發(fā)現,早治療的二級預防,從而降低醫(yī)療成本,促進人群健康。結果:1.新疆烏魯木齊市社區(qū)中年人群844人中,NAFLD患者檢出456人,患病率為54.03%;2.維吾爾族和漢族NAFLD的患病率分別為64.71%和48.66%,維吾爾族人群高于漢族人群,差異有統(tǒng)計學意義(P0.05);3.在男性人群中,NAFLD組與正常組人群的BMI、SBP、DBP、腰圍、臀圍、頸圍、皮下脂肪厚度、UA、ALT水平相比有統(tǒng)計學意義(P0.05),在女性人群中,NAFLD組與正常組人群的BMI、SBP、DBP、腰圍、臀圍、頸圍、皮下脂肪厚度、FPG、UA、ALT、AST水平相比均具有統(tǒng)計學意義(P0.05);4.在維吾爾族人群中,NAFLD組與正常組人群BMI、SBP、腰圍、臀圍、皮下脂肪厚度、FPG、ALT、AST對比均具有統(tǒng)計學意義(P0.05),在漢族人群中,NAFLD組與正常組人群的BMI、SBP、DBP、腰圍、臀圍、頸圍、皮下脂肪厚度、ALT、AST水平相比均具有統(tǒng)計學意義(P0.05);5.既往史與NAFLD單因素logistic回歸分析結果顯示,糖尿病、高脂血癥、膽囊炎、膽石癥均與NAFLD具有相關性(P0.05);6.臨床觀察指標與NAFLD單因素logistic回歸分析結果顯示,BMI、SBP、DBP、腰圍、臀圍、頸圍、皮下脂肪、FPG、ALT、AST水平均與NAFLD具有相關性(P0.05);7.男性肥胖指標預測NAFLD發(fā)生,腰圍、臀圍、皮下脂肪、頸圍的曲線下面積依次為0.711、0.668、0.652、0.649;女性肥胖指標預測NAFLD發(fā)生,腰圍、臀圍、頸圍、皮下脂肪的曲線下面積依次為0.790、0.760、0.710、0.697;8.將篩檢出的NAFLD患者進行社區(qū)干預后,干預組有17例患者痊愈,對照組有10例患者痊愈(干預前兩組NAFLD患病程度進行統(tǒng)計學檢驗,具有可比性,2x=0.892,P=0.640);9.干預組與對照組NAFLD患者在干預前后,BMI、SBP、DBP、腰圍、臀圍、頸圍、皮下脂肪厚度、FPG、UA、ALT、AST水平均有所變化;10.干預組與對照組干預結局時期BMI、SBP、DBP、腰圍、頸圍、皮下脂肪厚度、UA水平變化值均具有統(tǒng)計學意義(P0.05)。結論:1.烏魯木齊市社區(qū)中年人群的NAFLD患病率較高,提示應對烏市社區(qū)居民NAFLD的防治應引起更多關注;2.NAFLD的發(fā)生與多種因素相關,包括性別、年齡、BMI、血壓、腰圍、臀圍、頸圍、皮下脂肪厚度、空腹血糖、尿酸、丙氨酸氨基轉移酶、天冬氨酸氨基轉移酶等;3.NAFLD的防治主要是去除致病危險因素,通過健康教育,注意飲食調整、科學有效控制體重、定期體檢,改善不良生活行為方式及習慣、注重規(guī)律地運動及鍛煉,必要時采用藥物治療等一系列綜合措施,達到消退NAFLD,進而有效防止疾病發(fā)展與并發(fā)癥發(fā)生。
[Abstract]:Objective: the purpose of this study was to investigate the prevalence of Nonalcoholic fatty liver disease (NAFLD) in middle-aged people in Urumqi community, to analyze the epidemic characteristics and the main related risk factors, and to intervene in the found NAFLD patients by community intervention in order to reduce the degree of fatty liver and promote the overall health of the patients. In order to provide a theoretical basis for the prevention and intervention of the disease in the future, a cluster sampling method is adopted in a street community as a unit, with a questionnaire, physical measurement (height, weight, blood pressure, waist circumference, hip circumference, subcutaneous fat thickness), blood biochemistry (including liver function, fasting blood glucose, uric acid), and B of the abdominal liver. To investigate the prevalence of NAFLD in the middle age community of the community, and to analyze the main related risk factors, and to divide the NAFLD patients into the community as the intervention group and the control group to explore the scientific intervention methods so as to achieve the early detection and the two level prevention of early treatment, thus reducing the cost of medical treatment and promoting the promotion of medical costs. Results: among the 844 middle-aged people in 1. Xinjiang Urumqi community, 456 were detected in NAFLD patients, the prevalence rate was 54.03%, and the prevalence rate of 2. Uygur and Han nationality was 64.71% and 48.66% respectively. The Uygur population was higher than the Han population, the difference was statistically significant (P0.05); 3. in the male population, and the B of the NAFLD group and the normal group. MI, SBP, DBP, waist circumference, hip circumference, neck circumference, subcutaneous fat thickness, UA, ALT levels were statistically significant (P0.05). In female population, the NAFLD group was statistically significant compared with the normal group of BMI, SBP, DBP, waist circumference, neck circumference, subcutaneous fat thickness, FPG, UA, and normal levels. 4. in Uygur population, normal group and normal Group BMI, SBP, waist circumference, hip circumference, subcutaneous fat thickness, FPG, ALT, AST were statistically significant (P0.05). In the Han population, BMI, SBP, DBP, waistline, hip circumference, neck circumference, subcutaneous fat thickness, ALT, AST level were statistically significant in the Han population. 5. past history and single factor regression analysis The results showed that diabetes, hyperlipidemia, cholecystitis, cholelithiasis were all associated with NAFLD (P0.05); 6. the clinical observation index and NAFLD single factor Logistic regression analysis showed that BMI, SBP, DBP, waist circumference, hip circumference, subcutaneous fat, FPG, ALT, AST water were associated with NAFLD (P0.05); 7. male obesity indicators predicted occurrence, waist The area under the curve of circumference, hip circumference, subcutaneous fat and neck circumference was 0.711,0.668,0.652,0.649 in turn; female obesity index predicted NAFLD, waist circumference, hip circumference, neck circumference, and subcutaneous fat under the curve area of 0.790,0.760,0.710,0.697; 8. the NAFLD patients screened out for community prognosis, 17 patients in the intervention group were healed, and 10 cases in the control group. The patients were cured (statistical test of the two groups of NAFLD diseases before intervention, comparable, 2x=0.892, P=0.640); 9. the intervention group and the control group NAFLD patients before and after intervention, BMI, SBP, DBP, waist circumference, neck circumference, subcutaneous fat thickness, FPG, UA, ALT, AST water change; 10. intervention group and the control group intervention outcome period BMI, wealth, waist circumference The changes in the neck circumference, the thickness of the subcutaneous fat and the UA level were all statistically significant (P0.05). Conclusion: 1. the prevalence of NAFLD in middle-aged people in Urumqi community is higher, suggesting that the prevention and control of NAFLD should be more concerned. The occurrence of 2.NAFLD is related to a variety of factors, including sex, age, BMI, blood pressure, waist circumference, hip circumference, and neck circumference. The thickness of subcutaneous fat, fasting blood sugar, uric acid, alanine aminotransferase, aspartate aminotransferase, and so on. The prevention and control of 3.NAFLD is mainly to remove the risk factors of pathogenic factors. Through health education, attention to diet adjustment, scientific and effective control of weight, regular physical examination, improvement of unhealthy lifestyle and habits, and attention to regular exercise and exercise, necessary to exercise and exercise, need to be regularly exercised and exercised. Necessary A series of comprehensive measures such as drug therapy were used to achieve NAFLD regression and effectively prevent disease progression and complications.

【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.2

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