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1、暨南大學(xué)碩士學(xué)位論文慢性丙型肝炎病毒感染者罹患代謝綜合征對肝臟病變的影響Z=2.034,P=0.042)。按照血糖、血壓、血脂、尿酸水平、BMI指數(shù)等進行分2組,各組組間在AST、ALT、γ-谷氨酰轉(zhuǎn)移酶(gamma-glutamyltransferase,γ-GT)、TBil、甲胎蛋白(alphafetoprotein,AFP)、APRI評分、HCVRNA定量、血漿纖維蛋白原(plasmafibrinogen,F(xiàn)IB)、凝血酶時間(thrombintime,TT)值差異無統(tǒng)計學(xué)意義。代謝性指標(biāo)與肝臟相關(guān)指標(biāo)多元線性回歸分析顯示,ALT、γ-GT與甘油三酯呈正相關(guān)(分別為F
2、=5.174,P=0.025;F=36.968,P=0.0002)。而在AST與相關(guān)代謝性指標(biāo)中,總膽固醇與AST水平呈負相關(guān),甘油三酯水平與AST水平正相關(guān)(F=4.542,P=0.005)。總膽固醇水平與白蛋白水平(標(biāo)準(zhǔn)化偏回歸系數(shù)=0.417,F(xiàn)=22.068,P=0.0004)、甘油三酯水平與FIB水平負相關(guān),總膽固醇水平與FIB水平正相關(guān)(F=3.288,P=0.045)。甘油三酯水平與肝纖維化指標(biāo)FIB-4及APRI正相關(guān)(分別為F=6.582,P=0.002;F=8.107,P=0.0006)。脂肪肝則與BMI指數(shù)呈正相關(guān),并且當(dāng)BMI>24時,脂肪肝發(fā)病風(fēng)險
3、OR值為4.092(P=0.025)。結(jié)論:HCV感染罹患代謝綜合征患者與HCV感染不合并代謝綜合征患者相比較,前者的肝臟炎癥反應(yīng)程度更重,肝臟合成功能也偏低,并且肝臟纖維化程度更高。對于HCV感染伴有代謝綜合征患者,控制體重、血壓、血糖及甘油三酯水平將有助于改善肝臟功能,減輕肝臟炎癥反應(yīng)及脂肪肝的發(fā)生,延緩肝臟纖維化進程。關(guān)鍵詞:丙型肝炎病毒;代謝綜合征;肝臟病變;影響III萬方數(shù)據(jù)暨南大學(xué)碩士學(xué)位論文慢性丙型肝炎病毒感染者罹患代謝綜合征對肝臟病變的影響AbstractObjective:ToinvestigatetheeffectofchronichepatitisCv
4、irus(HCV)infectioncomplicatedbymetabolicsyndromeontheprogressandprognosisofliverdisease,andtherelationshipbetweenthemetabolicsyndromeandliverfunctionsinpatientswithHCVinfection.Methods:186patientswithchronicHCVinfectionwererecruitedfromin-patientsatthefirstAffiliatedHospitalofJinanUniversi
5、tybetweenJanuary1,2009andJanuary31,2014.Atotalof186patientsincluded109malecasesand77femalecases.Thecharacteristicdataandlaboratoryresultssuchasdiagnosis,casehistory,height,weight,vitalsigns,bloodroutinetest,serumcoagulationandliverfunctions,biochemicalmarkers,liverimaging,liverfibrosisinde
6、x,HCVviralloadandserologicmarkersofHBV.Theclinicaldiagnosisandparametersofallpatientswereanalyzed.Thepatientsweredividedintothreegroups,e.g.thegroupsoflivercirrhosis(GroupA),fattyliver(GroupB),neitherlivercirrhosisnorfattyliver(GroupC)forcomparisonofclinicalandbiologicalmarkers,andtheassoc
7、iationofdegreesofliverdiseasewithmetabolicbiomarkers.Bodymassindex(BMI),bloodpressures,serumglucose,lipid,uricacidlevelsaccordingtoChinesediagnosisguidelinesandtreatmentweredividedintonormalgroupandabnormalgroupforcomparisonofliverinflammationmarkers(alanineam