本文關(guān)鍵詞：廣西體檢人群脂肪肝檢出率及其影響因素的研究　出處：《廣西醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 脂肪肝 檢出率 影響因素 流行病學(xué)調(diào)查

【摘要】：目的：了解廣西體檢人群脂肪肝患病情況及其相關(guān)影響因素,為預(yù)防和控制脂肪肝的發(fā)生提供科學(xué)依據(jù)。方法：1、調(diào)查對(duì)象：以2014年5月至2015年11月由廣西醫(yī)科大學(xué)第一附屬醫(yī)院體檢中心進(jìn)行體檢的來(lái)自南寧市、桂平市、容縣、平南4個(gè)市縣部分單位組織的集體體檢的5631名健康體檢人員作為研究對(duì)象。2、資料收集方法：(1)流行病學(xué)調(diào)查問卷：采用統(tǒng)一設(shè)計(jì)的流行病學(xué)調(diào)查問卷進(jìn)行調(diào)查,收集相關(guān)的資料,包括研究對(duì)象的人口學(xué)資料、飲食習(xí)慣、工作及運(yùn)動(dòng)情況、精神及健康狀態(tài)。(2)體格檢查：包括身高、體重、血壓等。(3)實(shí)驗(yàn)室檢測(cè)：包括總膽固醇、甘油三酯和糖化血紅蛋白等。(4)B超檢查和心電圖檢查：包括肝、膽、脾、腎等腹部檢查。3、統(tǒng)計(jì)學(xué)方法：將流行病學(xué)調(diào)查資料、體格檢查資料和實(shí)驗(yàn)室檢查的資料采用EpiData3.1軟件進(jìn)行雙錄入,建立數(shù)據(jù)庫(kù)文件,經(jīng)一致性檢驗(yàn)無(wú)誤后將數(shù)據(jù)轉(zhuǎn)為SPSS16.0數(shù)據(jù)文件。先對(duì)資料進(jìn)行描述性分析,計(jì)量資料且呈正態(tài)分布的,使用均數(shù)±標(biāo)準(zhǔn)差(x±s)進(jìn)行描述；計(jì)數(shù)資料采用率或構(gòu)成比進(jìn)行描述。在統(tǒng)計(jì)描述的基礎(chǔ)上進(jìn)行統(tǒng)計(jì)推斷,比較脂肪肝人群與非脂肪肝人群的AST、UA、TG、HDL、LDL、紅細(xì)胞計(jì)數(shù)等生化指標(biāo)均數(shù)的差異采用兩樣本均數(shù)比較的t檢驗(yàn),不同水平研究因素脂肪肝檢出率差異的假設(shè)檢驗(yàn)采用2檢驗(yàn)。影響脂肪肝患病的因素采用非條件Logistic回歸模型進(jìn)行分析,將單因素分析有意義的因素納入模型進(jìn)行分析,變量的篩選采用前進(jìn)法,檢驗(yàn)水準(zhǔn)為0.05,以P≤0.05為差異具有統(tǒng)計(jì)學(xué)意義。所有統(tǒng)計(jì)分析均使用SPSS16.0統(tǒng)計(jì)軟件進(jìn)行。結(jié)果：1、研究對(duì)象一般情況5631名體檢者,南寧市2702名,占47.98%；桂平市2240名,占39.98%；容縣374名,占6.64%；平南縣315名,占5.59%。男性2968人,占52.7%,女性2663人,占47.3%,男女比例為1.11：1。年齡最小20歲,最大94歲,20-35歲組1654人,占29.4%；35~50歲組2090人,占37.1%；50~65歲組1247人,占22.1%；65歲以上組640人,占11.4%。2、調(diào)查對(duì)象脂肪肝患病情況調(diào)查的5631名體檢者,脂肪肝患者1808人,檢出率為32.2%。來(lái)自南寧市區(qū)、桂平市、容縣、平南縣四個(gè)地區(qū)的體檢人群脂肪肝標(biāo)化檢出率分別為26.27%、37.63%、22.32%、29.18%,差異有統(tǒng)計(jì)學(xué)意義(χ2=145.1,P0.001)。體檢人群中男性脂肪肝檢出率顯著高于女性(χ2=339.8,P0.01)。按青年、中年、中老年、老年分不同年齡組進(jìn)行比較,脂肪肝檢出率差異有統(tǒng)計(jì)學(xué)意義(P0.001)。3、研究因素不同水平脂肪肝患病情況超重和肥胖人群脂肪肝檢出率分別為50.65%、80.2%,均高于體重正常人群的13.19%(P0.05)。高血壓人群脂肪肝檢出率52.31%,高于血壓正常人群的21.37%(P0.05)。極輕、輕度、中度、重度體力勞動(dòng)強(qiáng)度的脂肪肝檢出率分別為32.4%、35.4%、26.4%、29.0%(P0.05)。睡眠狀態(tài)中嚴(yán)重不足、不足、一般、充足4個(gè)情況脂肪肝檢出率為26.5%、30.5%、35.7%、34.3%,四種睡眠狀態(tài)脂肪肝檢出率差異有統(tǒng)計(jì)學(xué)意義(P0.005)。從不飲酒、偶爾飲酒、戒酒、經(jīng)常飲酒4種飲酒的不同情況結(jié)果顯示體檢人群脂肪肝檢出率分別為26.7%、33.7%、36.6%、41.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。從不吸煙、偶爾吸煙、戒煙、經(jīng)常吸煙這4中吸煙情況人群脂肪肝檢出率為28.4%、35.4%、37.8,%、41.3%(P0.05)。肉類及肉制品較少、較多、很多三個(gè)情況的攝入量脂肪肝檢出率分別為31.4%、33.4%、37.4%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)、魚類及水產(chǎn)品不吃、較少吃、較多吃的人群脂肪肝檢出率分別為21.5%、29.4%、34.4%。清淡、適中、偏咸、高鹽4種食鹽的不同攝入量脂肪肝檢出率為29.9%、37.2%、40.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。豆類及豆制品不吃、偶爾、經(jīng)常吃的人群脂肪肝檢出率分別為33.9%、25.0%、20.2%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。脂肪肝組ALT、AST、UA、BUN、CR、TC、TG等生化指標(biāo)均值均高于非脂肪肝組；脂肪肝組的高密度脂蛋白均數(shù)低于非脂肪肝組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。4、脂肪肝相關(guān)因素單因素非條件logistic回歸分析結(jié)果顯示：地區(qū)、性別、年齡、超重、肥胖、高血壓、經(jīng)常飲酒、經(jīng)常吸煙、不同吸煙情況、偶爾和經(jīng)常吃魚、高鹽飲食、常吃豆制品、睡眠不足、中度勞動(dòng)強(qiáng)度、高血脂、高尿酸、高血糖、高膽固醇等因素與脂肪肝的發(fā)生有關(guān)。5、脂肪肝相關(guān)因素多因素非條件Logistic回歸分析結(jié)果顯示：年齡、超重、肥胖、經(jīng)常吸煙、高膽固醇血癥、高甘油三酯血癥、高AST、高ALT等因素與脂肪肝的發(fā)生有關(guān)。結(jié)論：廣西體檢人群脂肪肝檢出率較高。不同地方不同性別的脂肪肝檢出率有差異,男性35~歲脂肪肝檢出率最高,女性50~脂肪肝檢出率最高。年齡越大,脂肪肝的檢出率越高,中老年人是患脂肪肝的高危人群。肥胖、高血壓、高血脂飲酒、吸煙、愛吃魚和肉、口味偏咸可能增加脂肪肝的危險(xiǎn)性。中度體力勞動(dòng)、經(jīng)常吃豆類及豆制品、多飲水可能降低脂肪肝的檢出率。為控制脂肪肝,建議從控制體重、改善膳食等方面入手。
[Abstract]:Objective: to understand the prevalence of fatty liver and its related factors in Guangxi physical examination population, so as to provide a scientific basis for preventing and controlling the occurrence of fatty liver. Methods: 1 subjects: 5631 healthy volunteers from May 2014 to November 2015 by the examination center of the First Affiliated Hospital of Guangxi Medical University were selected from Nanning City, Guiping City, Rongxian County Province, 4 cities and counties part of the unit organization of collective examination as an object of study. 2, data collection methods: (1) epidemiological questionnaire: a unified designed epidemiological questionnaire was used to collect relevant information, including demographic data, dietary habits, work and exercise, mental health status. (2) physical examination: including height, weight, blood pressure, etc. (3) laboratory testing: including total cholesterol, triglycerides and glycosylated hemoglobin. (4) B ultrasound examination and electrocardiogram examination: including liver, bile, spleen, kidney and other abdominal examinations. 3, statistical methods: the epidemiological survey data, physical examination data and laboratory examination data were input by EpiData3.1 software, and database files were established. After consistency test, the data were converted to SPSS16.0 data files. First, descriptive analysis of data was made. Data were distributed normally, using mean + standard deviation (x + s), and counting data was described by rate or constituent ratio. The statistical inference based on statistical description, the difference of AST, UA, TG, HDL, LDL, red blood cell count and other biochemical indexes of fatty liver group and non fatty liver people were using two samples t test, factors of different levels of fatty liver detection hypothesis test rate difference by 2 test. Influencing factors of fatty liver disease by non conditional Logistic regression model analysis, univariate analysis significant factors included in the model analysis, the selection of the variables using the forward method, the test level is 0.05, statistically significant difference in P is less than or equal to 0.05. All statistical analysis was carried out using SPSS16.0 statistical software. Results: 1. Generally speaking, 5631 subjects were examined, 2702 in Nanning, 47.98%, 2240 in Guiping, 39.98%, 374 in Rongxian County, 6.64% in Pingnan County and 5.59% in Pingnan County. 2968 men, 52.7% and 2663 women, accounting for 47.3%, and the male and female ratio of 1.11:1. The youngest is 20 years old, the oldest is 94 years old, 20-35 years old group 1654 people, account for 29.4%; 35~50 year old group 2090 people, account for 37.1%; 50~65 year old group 1247 person, 22.1%; 65 year old group above 640 person, occupy 640. 2, 5631 patients with fatty liver disease survey, 1808 patients with fatty liver, the detection rate was 32.2%. The standardized detection rates of fatty liver were 26.27%, 37.63%, 22.32%, 29.18%, respectively, from four areas of Nanning, Guiping, Rongxian County and Pingnan County. The difference was statistically significant (chi 2=145.1, P0.001). The detection rate of fatty liver in male was significantly higher than that of women (x 2=339.8, P0.01). Compared with young, middle-aged, middle-aged and old age groups, the difference in the detection rate of fatty liver was statistically significant (P0.001). 3, the prevalence of fatty liver is different at different levels of research. The detection rates of fatty liver in overweight and obesity groups are 50.65% and 80.2%, respectively, which are higher than those in normal weight population (13.19%) (P0.05). The detection rate of fatty liver in hypertensive people was 52.31%, which was higher than that of 21.37% (P0.05) of normal blood pressure group. Light, mild, moderate and severe physical labor intensity of fatty liver detection rates were 32.4%, 35.4%, 26.4%, 29% (P0.05). In the 4 cases of severe, insufficient, general and sufficient sleep condition, the detection rate of fatty liver was 26.5%, 30.5%, 35.7%, 34.3%. There was a significant difference in the detection rate of fatty liver among four sleep states (P0.005). The results showed that the prevalence of fatty liver in physical examination group was 26.7%, 33.7%, 36.6%, 41%, respectively. No significant difference was found in the 4 alcohol drinking cases. Occasionally, drinking, drinking and drinking regularly. The difference was statistically significant (P0.05). The prevalence of fatty liver was 28.4%, 35.4%, 37.8,%, and 41.3% (P0.05) in the 4 people who had never smoked, occasionally smoked, smoked, and smoked frequently. Meat and meat products less, more, many three cases of fatty liver intake rate were 31.4%, 33.4%, 37.4%, the difference was statistically significant (P0.05), fish and aquatic products do not eat, eat less, eat more fatty liver crowd detection rates were 21.5%, 29.4%, 34.4%. The detection rates of fatty liver of 4 kinds of salt were 29.9%, 37.2% and 40% for light, moderate, salty, and high salt, and the difference was statistically significant (P0.05). The detection rates of fatty liver in the people who did not eat, occasionally and regularly eat were 33.9%, 25% and 20.2%, respectively, and the difference was statistically significant (P0.05). The mean values of ALT, AST, UA, BUN, CR, TC, TG and other biochemical indexes in fatty liver group were all higher than those in non fatty liver group. The HDL in fatty liver group was lower than that in non fatty liver group, the difference was statistically significant (P0.05). 4, fatty liver related factors of single factor non conditional logistic regression analysis showed that gender, age, region, overweight and obesity, hypertension, smoking and drinking, smoking, regular smoking, and occasionally often eat fish, high salt diet, eat soy products, lack of sleep, moderate labor intensity, high blood fat, high uric acid, high blood sugar, high cholesterol and other factors related to the occurrence of fatty liver. 5, fatty liver related factors, multivariate Logistic regression analysis showed that age, overweight, obesity, frequent smoking, hypercholesterolemia, hypertriglyceridemia, high AST and high ALT were related to the occurrence of fatty liver. Conclusion: the detection rate of fatty liver in Guangxi physical examination population is high. There is a difference in the detection rate of fatty liver between different sexes in different places, male 35~ years old fatty liver
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R575.5

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