本文選題：2型糖尿病　切入點：非酒精性脂肪性肝病　出處：《吉林大學》2017年碩士論文

【摘要】：目的:分析2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者早期肝纖維化的相關因素,并對其危險性進行淺要分析。方法:選取2015年2月至2015年12月吉林大學中日聯(lián)誼醫(yī)院內分泌科住院的137例2型糖尿病患者,所有患者均行肝臟彩超檢查并明確診斷為NAFLD,分別采集病史資料、臨床生化指標、并算出非酒精性脂肪性肝纖維化評分(NAFLDFS)與胰島素抵抗指數(HOMA2-IR)。將研究對象按NAFLDFS的診斷閾值進行分組,其中NAFLDFS-1.455為A組,-1.455≤NAFLDFS≤0.676之間為B組,NAFLDFS0.676為C組;比較各組間一般臨床資料和生化指標的差異,用多項Logistics回歸分析得出影響肝纖維化的危險因素。結果:(1)超聲診斷的NAFLD合并T2DM患者共137例(男//女,76/61),其中NAFLDFS0.676的為33例(24.1%),NAFLDFS在-1.455~0.676之間者83例(60.6%),NAFLDFS-1.455者21例(15.3%)。(2)Pearson分析顯示進展性肝纖維化與年齡、BMI、SBP、HOMA2-IR呈線性正相關;與RBC、WBC、PLT、ALT、AST、TG、TC呈線性負相關。(3)Logistic回歸分析結果顯示HOMA-IR、收縮壓升高和RBC、WBC、TC減少是T2DM合并NAFLD肝纖維化的危險因素(OR=1.279、1.076、0.374、0.674、0.574)。結論:胰島素抵抗、收縮壓與肝纖維化評分成正相關,提示其是肝纖維化的危險因素;而白細胞、紅細胞及總膽固醇與肝纖維化評分呈負相關,提示其是肝纖維化的保護性因素。
[Abstract]:Objective: to analyze the related factors of early hepatic fibrosis in patients with type 2 diabetes mellitus (T2DM) combined with NAFLD. Methods: from February 2015 to December 2015, 137 patients with type 2 diabetes were selected from the Department of Endocrinology, Sino-Japanese Friendship Hospital of Jilin University. All patients were examined with liver color Doppler ultrasound and diagnosed as NAFLD.The history data and clinical biochemical indexes were collected respectively. The nonalcoholic fatty liver fibrosis score (NAFLDFSs) and the insulin resistance index (HOMA2-IRN) were calculated. The subjects were grouped according to the diagnostic threshold of NAFLDFS, and the NAFLDFS-1.455 was between group A (-1.455 鈮，

本文編號：1665936