目的 探讨非酒精性脂肪性肝病(NAFLD)合并代谢综合征(MS)的患病情况、临床特点.方法 选取在我院体检中心体检诊断的NAFLD患者207例,按有无合并MS分为单纯NAFLD组114例,NAFLD合并MS组93例,比较两组患者的临床资料.结果 (1)NAFLD中合并MS的患病率为44.93％,两组患者的性别比及发病年龄无明显差异(P＞0.05)；(2)肝脏血清酶学指标:NAFLD合并MS组患者的ALT及AST和单纯NAFLD组相比无明显差异(P＞0.05),但AST/ALT＞1的发生率较单纯NAFLD组显著增多(P＜0.05)；(3)代谢指标:NAFLD合并MS组患者的腰围、甘油三酯、空腹血糖及血尿酸均较单纯NAFLD组明显增高(P＜0.05),但是血压、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇无明显差异(P＞0.05)；(4)并发症:NAFLD合并MS组冠心病、糖尿病及高血压病的发生率均较单纯NAFLD组显著增多(P＜0.05).结论 NAFLD合并MS患者的肝酶(AST/ALT＞1)异常及并发症发生率高,代谢异常程度严重,应给予有效的干预措施.%Objective To explore the morbidity and clinical characteristic of non-alcoholic fatty liver disease(NAFLD) with metabolic snydrome ( MS). Methods 207 patients with NAFLD were enrolled in this ssurvey. The subjects were divided into two groups;those only with NAFLD;those with both of the two diseases(NAFLD and MS). Clinical data in the two groups were evaluated. Results The prevalence of MS was 44.93% in the all NAFLD patients, there were no difference between two groups according to ratio of malet of emale and age distribution respectively( P >0.05). For alanine aminotransferase( ALT) and aspartate aminotransferase (AST) in the liver function, there were also no difference between two groups respectively ( P > 0.05) ,but incidence rate of AST/ALT > 1 in the patients with both of the two diseases(NAFLD and MS) was higher than that of patients only with NAFLD ( P < 0.05). For metabolic parameters, waist circumference, triglyceride, fasting plasma glucose and serum uric acid were significantly increased in the group with both of the two diseases(NAFLD and MS) ,compaing with those only with NAFLD(P <0.05). However,there were no difference in both group on blood pressure, serum total cholesterol,hish density lipoprotein cholesterol and low density lipoprotein cholesterol( P >0. 05) . Incidence rate of coronary heart disease,diabetes melitus and hypertension were higher in the group with both of the two diseases ( NAFLD and MS) than that in only NAFLD group( P <0.05). Conclusion The prevalence of abnormal liver function( AST/ALT > 1) and complications are high in patients with both of the two diseases ( NAFLD and MS) , extent of metabolic abnormality also high. Effective treatment should be taken to intervene NAFLD with MS.
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