本文選題：非酒精性脂肪肝　切入點：幽門螺旋桿菌　出處：《延安大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)是一些致命性疾病的潛在風(fēng)險,如肝衰竭、肝癌、心血管疾病等,近年來,它的發(fā)病率呈逐年上升趨勢,但是,目前卻沒有積極有效的治療NAFLD的方案,僅以改善生活方式和控制飲食熱量為NAFLD患者的金標準干預(yù)方案,因此本課題通過檢測NAFLD中血清幽門螺旋桿菌(helicobacter pylori,HP)抗體陽性率,分析HP感染與NAFLD發(fā)病的相關(guān)性,旨在提高NAFLD的診斷率,為抗HP感染應(yīng)用于治療NAFLD提供新的理論基礎(chǔ),為NAFLD提供更好、更經(jīng)濟、更有效的治療方案。方法:收集陜西省人民醫(yī)院健康體檢中心2016年3月-6月的體檢人員的體檢資料,所有人員均進行幽門螺旋桿菌檢查及腹部B超檢查,具有完整體檢資料數(shù)據(jù)的體檢者,經(jīng)過嚴格篩選納入本研究的共856人,男性476人,女性380人,根據(jù)腹部B超提示有無脂肪肝分為NAFLD組和對照組。采集的內(nèi)容包括體檢者一般資料,飲酒史,既往病史等。此外還有身高體重(BMI=體重/身高2),血壓,FBG、HP抗體、血常規(guī)、血脂(TC、TG、HDL、LDL)、肝腎功、尿酸、ESR、hs-CRP、HbA1C,腹部超聲檢查和頸部超聲檢查,進行單因素分析HP與NAFLD的關(guān)系以及相關(guān)變量與NAFLD的關(guān)系,然后根據(jù)單因素分析中得出與NAFLD發(fā)病有關(guān)的變量,進行多因素分析,納入logistic多元回歸分析得出NAFLD的獨立影響因子。結(jié)果:(1)202例NAFLD組72例HP抗體陽性,陽性率為35.64%,654例對照組145例HP抗體陽性,陽性率為22.17%,NAFLD組HP抗體陽性率明顯高于對照組,NAFLD組與對照組兩組比較P0.01;(2)單因素分析一般資料變量時,NAFLD組Age、SBP、DBP、FBG平均值均高于對照組,兩組間比較P0.01;男性NAFLD的患病率明顯高于女性,兩組間比較P0.01;而BMI≥25kg/cm2、SBP≥130 mmHg、DBP≥85mmHg、HB≥150g/L、FBG≥6.1mmol/L、尿酸M420umol/L,F360umol/L時,NAFLD患病率明顯升高,兩組比較P0.05;(3)單因素分析血脂,NAFLD組TC、TG、LDL平均值均高于對照組,HDL低于對照組,兩組間比較P0.001;當TC≥5.18mmol/L,TG≥1.7mmol/LDL≥3.37mmol/L時,NAFLD的患病率明顯升高,兩組間比較P0.001;(4)單因素分析肝功能指標時,NAFLD組ALT、AST、ALB平均值均高于對照組,兩組間比較P0.001,差異有統(tǒng)計學(xué)意義;肝功能中ALT40U/L,AST40 U/L時,NAFLD患病率明顯升高,兩組間比較P0.001;(5)把所有單因素分析得出與NAFLD發(fā)病有關(guān)的變量進行多因素分析,納入logistic多元回歸分析得出NAFLD的獨立影響因子,示HP抗體、BMI、尿酸的回歸系數(shù)分別為1.397、-0.358、-0.006,OR值分別為4.041、0.699、0.994,P0.05。結(jié)論:(1)在NAFLD組中,HP抗體陽性率明顯高于對照組,提示HP抗體與NAFLD的發(fā)病有相關(guān)性;(2)年齡、性別、BMI、血壓、血糖、血脂、血紅蛋白、血沉、尿酸、肝功指標(AST、ALT、ALB)與NAFLD的發(fā)病有相關(guān)性;(3)HP抗體、BMI、尿酸三者均是都是NAFLD發(fā)生的獨立影響因子。
[Abstract]:Objective: nonalcoholic fatty liver disease (nonalcoholic fatty liver disease, NAFLD) is a potential risk for some fatal diseases, such as liver failure, liver cancer, cardiovascular disease, in recent years, its incidence increased year by year, but there is no effective treatment for NAFLD, only the gold standard NAFLD intervention with the solution to the improvement of life style and diet control, so this research by detection of NAFLD in serum of Helicobacter pylori (Helicobacter pylori, HP) antibody positive rate, correlation analysis of HP infection and the pathogenesis of NAFLD, to improve the diagnostic rate of NAFLD, provide a new theoretical foundation for the application in the treatment of anti HP infection NAFLD, NAFLD to provide better, more economical, more effective treatment options. Methods: the physical examination data collected medical examination center of Shaanxi People's Hospital health physical examination personnel in March 2016 -6 month, all the staff are quiet Clo examination and abdominal ultrasonography, with complete examination data of examination, after strict selection into a total of 856 people in the study, 476 male and 380 female, according to abdominal ultrasound showed fatty liver was divided into NAFLD group and control group. The acquisition included body examination data, drinking the history of previous history. In addition to height and weight (BMI= weight / height 2), blood pressure, FBG, HP antibody, blood routine, blood lipid (TC, TG, HDL, LDL), liver and kidney function, uric acid, ESR, hs-CRP, HbA1C, abdominal ultrasonography and cervical ultrasonography, the relationship between the single factor analysis of relationship between HP NAFLD and related variables and NAFLD, and then calculated according to relevant variables and the incidence of NAFLD in univariate analysis, multivariate analysis, independent factor into logistic multivariate regression analysis of NAFLD. Results: (1) in 202 cases of NAFLD group, 72 cases were HP antibody positive, the positive rate was 35.6 4%,654渚嬪鐓х粍145渚婬P鎶椾綋闃蟲，

本文編號：1590507