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中医湿证与非酒精性脂肪肝程度关联性分析 被引量:17
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作者 程亚伟 王婷 +4 位作者 王珊 丁一 蔡媛媛 薛兰霞 蔡敏 《西部中医药》 2020年第5期102-105,共4页
目的:探讨非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)中医湿证与脂肪肝程度的关联性。方法:将NAFLD患者110例按照中医辨证分为中医湿证组90例(湿浊证组41例、湿热证组33例、痰瘀证组16例)及非湿证组20例(气滞证组),另... 目的:探讨非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)中医湿证与脂肪肝程度的关联性。方法:将NAFLD患者110例按照中医辨证分为中医湿证组90例(湿浊证组41例、湿热证组33例、痰瘀证组16例)及非湿证组20例(气滞证组),另外招募正常对照组30例。用肝纤维化脂肪肝一体化诊断检查仪(FibroScan-CAP,502B)检测各组患者血脂、肝功能等,比较中医湿证(湿浊证、湿热证、痰瘀证)、非湿证(气滞证)与血脂、肝功能等的关系。结果:1)110例NAFLD患者中非湿证组(气滞证组)20例(18.2%),湿证组90例(81.8%),湿证患者比例大于非湿证患者,提示NAFLD的发生发展与中医湿证关系密切。2)中度脂肪肝非湿证组(气滞证组)占比最大,为75.0%(15/20),与湿证各组比较差异有统计学意义(P<0.05);重度脂肪肝中非湿证组(气滞证组)与湿证各组比较,差异有统计学意义(P<0.05),且痰瘀证组占比最大,为68.7%(11/16),与非湿证组、湿浊证组比较差异有统计学意义(P<0.05),提示各组脂肪肝程度从轻到重依次为:非湿证(气滞证)<湿浊证/湿热证<痰瘀证。3)与非湿证组比较,湿证各组谷草转氨酶(glutamic-oxalacetic transaminease,AST)、谷丙转氨酶(glutamic-pyruvic transaminase,ALT)、甘油三酯(triglyceride,TG)、谷氨酰转移酶(gamma-glutamyl transferase,GGT)水平高于非湿证组,差异具有统计学意义(P<0.05);痰瘀组总胆固醇(total cholesterol,TC)、TG、AST、ALT、碱性磷酸酶(alkaline phosphatase,ALP)、GGT水平升高最显著,痰瘀组与TC(R=0.446,P=0.003)、TG(R=0.377,P=0.014)、AST(R=0.403,P=0.008)、ALT(R=0.449,P=0.003)、ALP(R=0.408,P=0.007)有较强相关性。结论:非酒精性脂肪肝的发生和发展与中医湿证密切相关,且湿证与脂肪肝程度、血脂、肝功能等指标呈正相关,为中医“聚湿成痰、痰瘀互结”理论提供了数据支持,为NAFLD的早诊断、早干预及制定更合理化的管理及诊治方案提供了数据支持。 展开更多
关键词 非酒精性脂肪肝 中医湿证 fibroscan-cap 脂肪肝程度
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基于CAP技术探讨非酒精性脂肪肝中医湿证与脂肪度的关联性研究 被引量:4
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作者 程亚伟 丁一 +4 位作者 蔡媛媛 王婷 黄家彦 王珊 薛兰霞 《世界科学技术-中医药现代化》 CSCD 北大核心 2019年第8期1766-1771,共6页
目的探讨非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)中医湿证、非湿证各组与FibroScan-CAP检测结果、血脂、肝功能等指标的关联性。方法 2017年3月至2018年3月,在海南省中医院按照课题纳入标准和排除标准收集NAFLD患者11... 目的探讨非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)中医湿证、非湿证各组与FibroScan-CAP检测结果、血脂、肝功能等指标的关联性。方法 2017年3月至2018年3月,在海南省中医院按照课题纳入标准和排除标准收集NAFLD患者110例,按照中医辨证分为中医湿证组90例(包括:湿浊证组41例、湿热证组33例、痰瘀证组16例)、非湿证组20例(气滞证组),另外收集正常对照组30例。对各组进行肝纤维化脂肪肝一体化诊断检查仪(FibroScan-CAP,502B)检查并抽血检测血脂、肝功能等,比较中医湿证(湿浊证、湿热证、痰瘀证)、非湿证(气滞证)不同组与FibroScan-CAP检测结果、血脂、肝功能等指标的关系。结果①课题组收集到符合要求的NAFLD患者110例,其中,非湿证组(气滞证组)20例(18.2%),湿证组90例(81.8%),湿证患者比例远远大于非湿证患者,提示NAFLD的发生发展与中医湿证关系密切;②中度脂肪肝中,非湿证组(气滞证组)75%占比最大,与湿证三组比较均存在统计学差异(P <0.05)。重度脂肪肝中,非湿证组(气滞证组)与湿证三组比较,差异均存在统计学意义(P <0.05),且痰瘀证组68.7%占比最大,与非湿证组、湿浊证组比较差异存在统计学意义(P <0.05)。提示各组脂肪肝程度排序,从轻到重依次为:非湿证(气滞证)-湿浊证/湿热证-痰瘀证;③对照组、非湿证组、湿证三组之间CAP值、LMS值比较显示递增趋势,依次为:对照组-非湿证组-湿浊证-湿热证-痰瘀证;④对照组、非湿证组、湿证三组之间TC、TG、AST、ALT和GGT表达水平呈递增趋势,依次为对照组-非湿证组-湿浊证-湿热证-痰瘀证。结论非酒精性脂肪肝的发生和发展与中医湿证密切相关,且湿证与FibroScan-CAP检测结果、血脂、肝功能等指标呈正相关,为中医"聚湿成痰、痰瘀互结"理论提供了数据支持,为NAFLD的早诊断、早干预及制定更合理化的管理及诊治方案提供了数据支持和思路。 展开更多
关键词 非酒精性脂肪肝 中医湿证 fibroscan-cap 血脂 肝功能
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酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎患者的疗效观察 被引量:3
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作者 李伟娜 袁琳卉 +1 位作者 胡豆豆 金文文 《中国肝脏病杂志(电子版)》 CAS 2017年第3期80-84,共5页
目的探讨酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱对非酒精性脂肪性肝炎(NASH)的疗效。方法选取2014年1月至2015年12月于青岛市市立医院门诊及住院治疗的非酒精性脂肪性肝炎患者84例为研究对象,随机分为观察组和对照组,每组42例,观察组... 目的探讨酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱对非酒精性脂肪性肝炎(NASH)的疗效。方法选取2014年1月至2015年12月于青岛市市立医院门诊及住院治疗的非酒精性脂肪性肝炎患者84例为研究对象,随机分为观察组和对照组,每组42例,观察组患者给予酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱胶囊口服,对照组患者单独给予多烯磷脂酰胆碱胶囊口服,疗程均为24周,比较两组患者治疗前后肝功能(ALT、AST、GGT)、血脂(TG、TC)、血清内毒素及Fibroscan-CAP值的变化。结果观察组和对照组患者的ALT、AST、GGT、TG、TC、血清内毒素及Fibroscan-CAP值均较治疗前降低,差异有统计学意义(P均<0.001)。治疗后观察组患者的ALT、AST、GGT、TG、TC、血清内毒素及Fibroscan-CAP值的下降水平优于对照组,差异有统计学意义(t值分别为4.600、4.039、2.655、4.500、4.151、4.886和2.723,P均<0.05)。结论酪酸梭菌二联活菌胶囊通过调节NASH患者肠道菌群,减轻肠源性的内毒素血症,从而降低血脂水平、减轻肝脏脂肪沉积及肝功能损伤,可用于NASH的辅助治疗。 展开更多
关键词 脂肪性肝炎 非酒精性 酪酸梭菌二联活菌胶囊 肠道菌群 内毒素 fibroscan-cap
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超声弹性检测评价脂肪肝的应用研究 被引量:10
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作者 徐晓鸾 孟繁坤 孙丽娟 《医学影像学杂志》 2016年第10期1843-1846,共4页
目的探讨利用瞬时弹性扫描仪(Fibro Scan)测量肝脏受控衰减参数(controlled attenuation parameters,CAP),分析其与肝穿所得病理脂肪变性程度的相关性。方法对102例经超声引导下肝脏穿刺证实存在肝细胞脂肪变性的慢性乙型肝炎患者及非... 目的探讨利用瞬时弹性扫描仪(Fibro Scan)测量肝脏受控衰减参数(controlled attenuation parameters,CAP),分析其与肝穿所得病理脂肪变性程度的相关性。方法对102例经超声引导下肝脏穿刺证实存在肝细胞脂肪变性的慢性乙型肝炎患者及非酒精性脂肪肝患者,应用Fibro Scan-502机器进行肝脏脂肪含量(CAP)测定。结果慢性乙型肝炎(CHB)合并脂肪肝患者56例,非酒精性脂肪肝(NAFLD)患者46例,测得的CAP值两组间差异无统计学意义(P=0.103),102例患者依据病理脂肪变性程度分为S0至S3期,各期CAP值如下:S0期为(237.61±42.32)d B/m,S1期为(259.96±28.06)d B/m,S2期为(316.13±37.48)d B/m,S3期为(332.00±49.53)d B/m,4期间CAP值差异有统计学意义(F=23.79,P<0.01)。CAP测值与肝脏病理脂肪变性程度呈正相关(r=0.660,P<0.01)。结论 CAP值可用于临床脂肪肝无创性诊断及分度。 展开更多
关键词 超声诊断 受控衰减参数 脂肪肝
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FibroScan在2型糖尿病合并NAFLD中的作用
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作者 李瑜 裴晓艳 +1 位作者 沈晖 金国玺 《包头医学院学报》 CAS 2020年第2期5-8,共4页
目的:探究FibroScan在2型糖尿病合并非酒精性脂肪性肝病(NAFLD)中的意义及应用。方法:选取正常对照组(N)23例,2型糖尿病(T2DM)98例,其中T2DM合并NAFLD患者(DMF)70例,不伴NAFLD患者(DM)28例;NAFLD诊断采用Fibroscan?502TOUCH诊断标准,根... 目的:探究FibroScan在2型糖尿病合并非酒精性脂肪性肝病(NAFLD)中的意义及应用。方法:选取正常对照组(N)23例,2型糖尿病(T2DM)98例,其中T2DM合并NAFLD患者(DMF)70例,不伴NAFLD患者(DM)28例;NAFLD诊断采用Fibroscan?502TOUCH诊断标准,根据受控衰减参数CAP数值判定CAP<240 dB/m为正常,NAFLD患者CAP≥240 dB/m;对患者的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、角蛋白-18(CK-18)及生化常规、糖化血红蛋白、胰岛β细胞功能等进行分析,探究FibroScan在T2DM合并NAFLD中的意义。结果:N组患者与T2DM组及DMF组相比,N组患者的IL-6、TNF-α、CK-18水平低于后两组(P<0.05);N组患者与DM组相比,IL-6、TNF-α、CK-18差异无统计学意义(P>0.05),DMF组患者的IL-6、TNF-α、CK-18水平均高于DM组患者(P<0.05);在相关性分析中,CAP与IL-6、TNF-α、CK-18呈正相关(P<0.05)。结论:FibroScan在T2DM合并NAFLD诊断中效果好于腹部彩超,FibroScan不仅可判断脂肪变性程度,还能反应肝脏炎症程度。 展开更多
关键词 FIBROSCAN CAP 2型糖尿病 NAFLD IL-6 TNF-Α CK-18
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Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry
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作者 Mamadou Sarifou Diallo Oumarou Youssouf +8 位作者 Abdoulatif Yaogo Djenabou Diallo Kadiatou Diallo Thierno Amadou Wann Ahmed Tidiane Diallo Mamadou Lamine Yaya Bah Mamdou Diakhaby Mamadou Aliou Kanté Djibril Sylla 《Open Journal of Gastroenterology》 CAS 2024年第4期125-138,共14页
Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis t... Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority. 展开更多
关键词 Cirrhosis Fibrosis Fibroscan/CAP Non-Alcoholic Hepatic Steatosis STEATOSIS CHU Conakry
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Factors Associated with Hepatic Steatosis in Black African Subjects with Chronic Viral Hepatitis B in Côte d’Ivoire
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作者 Kouamé Hatrydt Guillaume Dimitri Kissi Anzouan-Kacou Henriette Ya +5 位作者 Gogan Patricia Bangoura Aboubacar Demba Doffou Stanislas Adjeka Mahassadi Kouame Alassan Yao Bathaix Fulgence Mamert Attia Alain Koffi 《Open Journal of Gastroenterology》 2023年第10期328-337,共10页
Context/Objectives: With the progression of the global epidemic of obesity and metabolic syndrome, the coexistence of hepatic steatosis in patients with chronic viral hepatitis B (VHB) is becoming significant. The aim... Context/Objectives: With the progression of the global epidemic of obesity and metabolic syndrome, the coexistence of hepatic steatosis in patients with chronic viral hepatitis B (VHB) is becoming significant. The aim of this work was to determine the factors associated with hepatic steatosis assessed by a Fibroscan with Controlled Attenuation Parameter (CAP) in patients with chronic viral hepatitis B in Côte d’Ivoire. Methods: This was a cross-sectional and analytical study. Data was collected from February 15 to July 31, 2020 in a private hospital structure in the city of Abidjan in Côte d’Ivoire. We included 83 patients with chronic viral hepatitis B. These were black patients, having performed a Fibroscan/CAP during the recruitment period and consenting to participate in the study. Patients with significant alcohol consumption, a secondary cause of hepatic steatosis, or other liver disease regardless of the etiology associated with hepatitis B were not included. Results: The frequency of hepatic steatosis in chronic VHB carriers assessed by the CAP in our study population was 48.19% including 24.10% severe steatosis. Obesity and high LDL cholesterol were statistically correlated with the presence of steatosis in our patients. Patients who had steatosis on ultrasound were 5 times more likely to have steatosis on CAP. Significant fibrosis was not significantly associated with steatosis. Conclusion: Obesity and LDL hypercholesterolemia are the main factors associated with hepatic steatosis detected by Fibroscan/CAP in patients with chronic viral hepatitis B. 展开更多
关键词 Non-Alcoholic Fatty Liver Disease Chronic Viral Hepatitis B OBESITY Metabolic Syndrome Fibroscan/CAP AFRICA
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Fibroscan和Ultrasound診斷脂肪肝的比較
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作者 林肇聰 楊金桃 +1 位作者 譚少華 張振榮 《镜湖医学》 2019年第2期9-11,共3页
目的比較Fibroscan和Ultrasound診斷脂肪肝的一致性和靈敏度。方法回顧性分析在本院健康中心同時進行Fibroscan和Ultrasound檢查肝臟的363例患者,對比兩種檢測方法的診斷結果。結果以臨床常用的Ultrasound診斷的結果作為相對參考標準,Fi... 目的比較Fibroscan和Ultrasound診斷脂肪肝的一致性和靈敏度。方法回顧性分析在本院健康中心同時進行Fibroscan和Ultrasound檢查肝臟的363例患者,對比兩種檢測方法的診斷結果。結果以臨床常用的Ultrasound診斷的結果作為相對參考標準,Fibroscan的敏感度和特異性分別為87.98%及68.38%。Fibroscan檢出脂肪肝共232例,診斷陽性率為63.9%;Ultrasound檢出脂肪肝共208例,診斷陽性率為57.3%;差別具有統計學意義(P=0.007)。Fibroscan和Ultrasound診斷脂肪肝的一致性一般(Kappa=0.575,P<0.001)。根據Ultrasound結果分組:無脂肪肝組(155例)、輕度脂肪肝組(133例)及中重度脂肪肝組(75例),用秩和試驗比較三個組別的CAP(controlled attenuation parameter),差別具有統計學意義(P=0.001)。結論Fibroscan能夠定量診斷肝脂肪,與Ultrasound在脂肪肝檢測方面相比,有一致性,並且可能有較高的靈敏性,對於臨床上脂肪肝的診斷及監測治療效果具有一定的實用價值。 展开更多
关键词 超聲波 肝臟瞬時彈性記錄儀 脂肪肝 受控衰減參數
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